| 张静,鲁茜,石祥奎.亚甲基四氢叶酸还原酶C677T多态性与甲氨蝶呤治疗输卵管妊娠的相关性研究[J].安徽医药,2016,20(12):2335-2338. |
| 亚甲基四氢叶酸还原酶C677T多态性与甲氨蝶呤治疗输卵管妊娠的相关性研究 |
| Association between methylenetetrahydrofolate reductase C677T polymorphism and methotrexate for the treatment of tubal pregnancy |
| 投稿时间：2016-06-21 |
| DOI： |
| 中文关键词: 甲基四氢叶酸还原酶C677T 基因多态性 甲氨蝶呤 输卵管妊娠 |
| 英文关键词: Methylenetetrahydrofolate Reductase C677T Gene polymorphism Methotrexate Tubal pregnancy |
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| 中文摘要: |
| 目的 了解亚甲基四氢叶酸还原酶基因多态性与甲氨蝶呤(MTX)保守治疗宫外孕的疗效是否存在相关性,从而指导临床合理选用治疗方案。方法 收集MTX保守治疗的87例输卵管妊娠患者,均符合输卵管妊娠保守治疗的标准,分为有效组和无效组。比较两组患者治疗前的基本情况,包括年龄、体质量、停经天数、治疗前人绒毛膜促性腺激素值(HCG)、治疗前白细胞计数、治疗前丙氨酸氨基转移酶(ALT)。将87例血样提取DNA、检测亚甲基四氢叶酸还原酶C677T(MTHFR C677T)位点基因型,比较两组基因表型分布。结果 两组患者的一般资料差异无统计学意义；87例中,有效58例,无效29例；有效组中CC 型21例(36.21%),CT型 19例(32.76%),TT型 18例(31.03%),C等位基因的表达率为52.59%；无效组中CC型 2例(6.90%),CT 型13例(44.83%),TT 型14例(48.27%),C等位基因的表达率为29.31%。多种因素中,除患者的基因型外,其他因素与治疗效果相关性比较差异无统计学意义(P＞0.05)。有效组CC型表达率较无效组高,C等位基因在有效组中的表达明显高于无效组,且两组差异有统计学意义。结论 MTX对野生CC型的效果更佳,因此,检测MTHFR677基因型的意义重大,建议临床在使用MTX治疗输卵管妊娠之前最好进行该位点的检测,根据结果合理地选择治疗方案,避免治疗失败,减少不良反应的发生。 |
| 英文摘要: |
| Objective To investigate whether methylenetetrahydrofolate reductase (MTHFR) gene polymorphism was associated with the effectiveness of methotrexate (MTX) as conservative treatment for extrauterine pregnancy,hence providing guidance on the selection of appropriate therapeutic regimen.Methods Eighty-seven cases with tubal pregnancy who were hospitalized in Xuzhou MCH Care Hospital for MTX conservative treatment were recruited in the study.All cases met the criteria of conservative treatment for tubal pregnancy and were assigned to the responding group and non-responding group.The general data including age,body weight,duration of menopause,HCG before treatment,white blood cell count before treatment,ALT before treatment were compared between two groups.Blood samples were collected from 87 cases for the extraction of DNAs and testing of the genotypes of MTHFR677 locus.The distribution of phenotypes was compared between two groups.Results There were no significant differences in general data between two groups.In 87 cases,there were 58 responding cases and 29 non-responding cases;in those with responses,DNA extraction was not successful in two cases,and CC was detected in 21 cases (36.21%),CT in 19 cases (32.76%),TT in 18 cases (31.03%),and the rate of allele Cexpression was 52.59%;in the non-responding group,DNA extraction was not successful in 1 case,and CC was detected in 2 cases (6.90%),CT in 13 cases (44.83%),TT in 14 cases (48.27%),and the rate of allele Cexpression was 29.31%.The responding group exhibited higher rate of CC genotype than the non-responding group.The rate of allele Cexpression was also significantly higher in the responding group when compared with the non-responding group.Conclusions MTX is more effective in wild-type CC genotype.Therefore,it is very important to test the genotypes of MTHFR677.It is recommended to test the locus prior to the application of MTX for the treatment of tubal pregnancy and appropriately design therapeutic regimen based on testing results,thereby avoiding non-response to therapy and reducing incidence of adverse reactions. |
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