Study On The Correlation Between Lp-PLA2 Gene Polymorphism And Motor Function Outcome Of ICS Patients

Objective The aim of this study is to detect the frequencies of LP-PLA2 alleles and genotypes in patients receiving standard rehabilitation therapy after ICS,and to evaluate the correlation between LP-PLA2 gene polymorphism and motor function outcomes of patients after ICS.Method Fifty-four patients with acute ischemic stroke from 2018 to 2021 were recruited from Jiangsu Rongjun Hospital.Peripheral venous blood was collected on admission to extract genomic DNAs.and then the method of direct DNA sequencing was performed to detect these genotypes(R92H,V279F and A379V).All patients used clopidogrel bisulfate to against platelet aggregation without other anticoagulants and all patients received the standard rehabilitation therapy.This 2-h rehabilitation program including exercise therapy,occupational therapy,and functional electrical stimulation therapy was performed five days a week,for three months.Fugl-Meyer Assessment Scale(FMA)and Activities of daily Living(ADL)scale(modified Barthel index method,MBI)were performed to assess the outcomes before treatment and after 2 month-treatment.Result Nine patients discontinued their treatment.Blood samples of seven patients were failed in DNA purification and sequencing.Finally,thirty-eight patients completed the whole treatment and evaluation.The FMA scores and MBI scores of all patients after treatment were higher than those before treatment.However,the recovery of motor function after treatment is limited by the representation of difference value.Multiple linear regression analysis was used,with different genotypes at each site as independent variables,and FMA score and MBI score after treatment as dependent variables.The FMA scores were significantly different among ICS patients with different genotypes at the A379V locus after treatment,but the MBI scores were not significantly different.The backward selection was used to identify covariates(pre-treatment score,systolic blood pressure,total cholesterol)associated with the FMA score of ICS patients after treatment and included in the model.The FMA score of ICS patients with CT genotype after treatment was 9.4 points higher than that of CC genotype.The low score of CC genotype may also explain the reason to a certain extent for the poor improvement of the affected limb motor function after rehabilitation treatment in ICS patients.In this study,there was no statistical significance in genotypes of R92H and V279F between FMA scores or MBI scores before and after rehabilitation therapy.The number of cases in this study is deficient,so it is necessary to select more patients from multiple hospitals for the next research project.Conclusion By confirming the distribution of LP-PLA2 R92H,V279F and A379V genotypes and alleles in patients received rehabilitation therapy after ICS,it is helpful for the design of rehabilitation program in ICS patients.Rehabilitation therapy for patients of CT genotype at A379V site in the early stage may accelerate the rehabilitation process of patients effectively,and reduce the disability rate and mortality rate significantly.There was no significant correlation between different genotypes of R92H and V279F loci of Lp-PLA2 gene and the recovery degree of motor function of patients after ICS.