中国实用神经疾病杂志2025，Vol.28Issue(6)：661-667,7.DOI:10.12083/SYSJ.250617
基于高分辨率磁共振成像和rs556621单核苷酸多态性的颅内动脉粥样硬化所致缺血性卒中复发风险的研究
Study of recurrence of ischemic stroke in patients with intracranial atherosclerosis disease and single nucleotide polymorphism of rs556621 based on high-resolution magnetic resonance imaging
摘要
Abstract
Objective To investigate the association between intracranial atherosclerotic disease(ICAD)plaque morphology,single nucleotide polymorphism(SNP)of rs556621,and recurrence risk in patients with acute ischemic stroke(AIS).Methods A prospective single-center cohort study was conducted,enrolling 52 patients with AIS and ICAD admitted to the Department of Neurology,Shanghai General Hospital from March 2017 to September 2019.Clinical data related to AIS risk factors were collected,and all patients underwent high-resolution magnetic resonance imaging(HRMRI)within two weeks after admission to evaluate the morphological characteristics of culprit plaques.The rs556621 genotype was detected by real-time fluorescence quantitative PCR using TaqMan probes.All patients received standardized treatment and were followed up annually for stroke recurrence,and were divided into recurrent group and non-recurrent group,and univariate analyses was conducted to compare risk factors and plaque characteristics under dominant and recessive models between both groups.Multivariate Cox regression was used to analyze the effects of rs556621 genotype and plaque characteristics on stroke recurrence.Results During the follow-up of 2 years,11(21.15%)patients experienced recurrent ischemic strokes.Univariate analysis revealed significantly lower high-density lipoprotein cholesterol(HDL-C)levels(P=0.025)and higher NIHSS scores on admission(P=0.049)in recurrent patients.Patients carrying the TT genotype at rs556621 showed lower Alberta stroke program early CT scores(ASPECTS,P=0.036)and were significantly more prone to positive remodeling(P=0.031).Multivariate Cox regression indicated that the rs556621 TT genotype was an independent predictor of stroke recurrence(HR=4.599,95%CI:1.056-20.040,P=0.042).Although positive remodeling was more prevalent among recurrent cases,it did not reach statistical significance in the multivariate model(HR=4.009,95%CI:0.741-21.689,P=0.107).Conclusion rs556621 TT genotype is positively associated with ischemic stroke recurrence in ICAD patients,potentially exerting its influence indirectly by promoting positive plaque remodeling.关键词
颅内动脉粥样硬化性疾病/缺血性卒中/单核苷酸多态性/复发/高分辨率磁共振成像Key words
Intracranial atherosclerotic disease/Ischemic stroke/Single nucleotide polymorphism/Recurrence/High-resolution magnetic resonance imaging分类
临床医学引用本文复制引用
汪義富,王乔树..基于高分辨率磁共振成像和rs556621单核苷酸多态性的颅内动脉粥样硬化所致缺血性卒中复发风险的研究[J].中国实用神经疾病杂志,2025,28(6):661-667,7.基金项目
上海申康医院发展中心"促进市级医院临床技能与临床创新三年行动计划"疑难疾病精准诊治攻关项目(编号:16CR2046B) （编号:16CR2046B）
