| Background Cerebral Infarction is a major disease threatening human life and health,not only has a high incidence and recurrence rate,but also a high rate of disability.Aspirin is widely used in primary and secondary prevention of cerebral infarction due to its low cost and good antiplatelet effect.However,in some patients with cerebral infarction,the symptoms of gastrointestinal tract and respiratory tract were aggravated after taking aspirin,which led to the patients’ subjective reluctance or intermittent taking aspirin for secondary prevention,this condition,known as Aspirin intolerance,severely affects the secondary prevention of cerebral infarction.Risk factors for Aspirin intolerance include genetic factors,but more evidence is needed.Objectives To explore the relationship between the polymorphism of the TNF-α gene rs1799964,rs1800630 and aspirin intolerance in patients with recurrent cerebral infarction,and to provide evidence for early identification of patients with aspirin intolerance.Methods According to the inclusion criteria and exclusion criteria,80 patients with recurrent cerebral infarction were selected from the Department of Neurology of Shangqiu First People’s Hospital from January 2020 to December 2020.The General Clinical Data and detailed information of the selected patients were collected and the informed consent form was signed.3 ML blood of elbow vein was extracted within 24 hours after admission.The PCR products were detected and purified by DNA extraction and PCR amplification,and stored in-80 °C refrigerator.The TNF-α gene rs1799964 and rs1800630 were genotyped by 3730 XL sequencer.The 80 patients with recurrent cerebral infarction were divided into aspirin intolerance group and control group according to the grouping standard through 1-month follow-up and related clinical test results.Single factor analysis was conducted to compare the differences between the two groups of clinical data,auxiliary examination results,allele frequency and genotype by t test and chi-square test or Fisher precision,while multi-factor analysis was conducted by logistics regression.Results 1.The genotype distribution of TNF-α genes rs1799964 and rs1800630 in the enrolled population conforms to the Hardy-Weinberg equilibrium law（P>0.05）.2.The genotype distribution of TNF-α rs1799964 in AI group was 7 cases of TT genotype（36.84%）,11 cases of TC genotype（57.89%）and 1 cases of CC genotype（5.26%）;The genotypes of TNF-α rs1799964 in control group were cases of 44 cases TT genotype（72.13%）,14 cases of TC genotype（22.95%）and 3 cases of CC genotype（4.91%）.The genotype distribution of TNF-α rs1800630 in AI group was 8 cases of CC genotype（42.11%）,11 cases of CA genotype（57.89%）and 0 cases of AA genotype（0%）;The genotypes of TNF-α rs1800630 in control group were cases of 48 cases CC genotype（78.69%）,12 cases of CA genotype（19.67%）and 1 cases of AA genotype（1.64%）.3.Univariate analysis showed that there were significant differences between the two groups in digestive tract disease history,C Allele of rs1799964 of TNF-α gene and TC + CC genotype,A allele of rs1800630 of TNF-α gene and CA + AA genotype（P< 0.05）.There was no significant difference in age,sex,BMI,hypertension history,diabetes history,coronary heart disease history,smoking history,drinking history,blood lipid between the two groups（P > 0.05）.4.Logistic regression analysis showed that a history of gastrointestinal disease（OR=11.04,P=0.008）may be the risk factor for aspirin intolerance.Conclusions 1.The history of gastrointestinal disease may be a risk factor for aspirin intolerance in patients with recurrent cerebral infarction 2.In patients with recurrent cerebral infarction,allele C carrying genotype TC+ CC of rs1799964 and allele A carrying genotype CA+AA of rs1800630 were the risk factors for aspirin intolerance.In order to improve the secondary prevention effect of cerebral infarction,individualized therapy should be adopted for Ai high-risk patients with mutation genotype of rs179964 and rs1800630 of tnf-α gene... |
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