| Objective:To investigate the association of single nucleotide polymorphism(SNP)of Toll-like receptor 4(TLR4)with susceptibility to cerebral infarction,neurological deficits and short-term prognosis.The aim is to investigate the factors influencing the susceptibility to cerebral infarction,neurological deficits and short-term prognosis at the genetic level,and to provide a theoretical basis for individualized treatment of patients and prediction of clinical prognosis.Methods:(1)183 cases of new acute ischemic stroke patients who visited the Department of Neurology of the Affiliated Hospital of Right River Ethnic Medical College from March to December 2020 were screened as the experimental group.Ninety cases of healthy physical examination were screened as the control group during the same period,and general information,treatment and laboratory test indexes were collected from all experimental subjects,and a case-control study was used to analyze whether there were differences in the comparison of general information between the two groups.(2)The ligase detection reaction LDR technique was applied to detect the genetic polymorphism of TLR4rs10983755G/A and rs10116253T/C loci,and Hardy-weinberg equilibrium was used to test the population representativeness of TLR4 gene polymorphism.Theχ~2test in spss25.0statistical software was used to analyze whether the differences in genotype frequencies and allele frequencies between the case and control groups were statistically significant and to investigate the correlation between TLR4 gene polymorphisms and susceptibility to cerebral infarction.Multi-factor logistic regression analysis was performed for significant univariate indices,and riskiness analysis was performed after correction,with P<0.05 as the test level.(3)The National Institute of Health stroke scale(NIHSS)was used to score the neurological deficits of the case group on admission,with NIHSS≤6 scores rated as the light group and NIHSS>6 scores as the heavy group.The correlation between TLR4 gene polymorphism and neurological deficits was analyzed for differences using theχ~2test,and multifactor logistic regression analysis was performed for significant univariate indicators,corrected for riskiness,with P<0.05 as the test level.(4)The modified Rankin Scale(m RS)was used to score the daily living ability of the case groups 90 days after discharge from the hospital.m RS<2 was rated as the good prognosis group,and m RS≥2 was rated as the poor prognosis group.Theχ~2test was used to analyze the correlation between TLR4 gene polymorphisms and short-term prognosis in the case groups for differences.Multi-factor logistic regression analysis was performed for significant univariate indicators,corrected for riskiness,and P<0.05 was used as the test level.Results:(1)Compared with the control group,the differences in rs10983755G/A genotype frequency distribution(χ~2=18.391,P=0.000)and allele distribution(χ~2=16.783,P=0.000)in the cerebral infarction group were statistically significant.The differences in rs10116253C/T genotype frequency distribution(χ~2=7.044,P=0.030)and allele distribution(χ~2=5.583,P=0.018)in the cerebral infarction group were also statistically significant.A multifactorial logistic analysis of risk factors for cerebral infarction excluding confounding factors revealed that rs10983755G/A locus genotype frequency correlation still existed(OR=2.588,95%CI:1.467-4.566)and G allele(OR=2.657,95%CI:1.725-4.093)was an independent The rs10116253C/T locus genotype frequency correlation was present(OR=1.540,95%CI:0.984-2.410),and the T allele(OR=1.559,95%CI:1.077-2.256)was also an independent risk factor for cerebral infarction.(2)Correlation analysis of genetic polymorphisms and neurological deficits in the cerebral infarction group.rs10983755G/A genotype frequency distribution(χ~2=13.622,P=0.001)was statistically significant in the heavy group compared with the light group.rs10116253C/T genotype frequency distribution(χ~2=6.477,P=0.039)was also statistically significant.significance.Multivariate logistic regression excluding confounding factors revealed that the correlation of genotype frequency distribution at the rs10983755G/A locus remained(OR=2.513,95%CI:0.486-12.990).rs10116253C/T locus genotype frequency distribution correlation also existed(OR=1.848,95%CI:0.686-4.978).(3)Correlation analysis between genetic polymorphisms and short-term prognosis in the cerebral infarction group.rs10983755G/A genotype frequency distribution(χ~2=8.973,P=0.011)and allele distribution(χ~2=0.307,P=0.579)were statistically significant in the poor prognosis group compared with the good prognosis group.rs10116253C/T The differences in genotype frequency distribution(χ~2=6.422,P=0.040)and allele distribution(χ~2=5.865,P=0.015)were statistically significant.Multifactorial logistic regression excluding confounding factors revealed that the risk of poor prognosis was 1.523(OR=1.523,95%CI:0.750-3.092)for the GG genotype carrying the rs10983755G/A locus compared with the AA genotype;the risk of poor prognosis was 2.523(OR=1.523,95%CI:0.750-3.092)for the TT genotype carrying the rs10116253C/T locus compared with the CC genotype.The risk of poor prognosis was 2.240(OR=2.240,95%CI:1.194-4.201),and allele T(OR=1.472,95%CI:1.076-2.013)may be an independent risk factor for short-term prognosis of cerebral infarction.Conclusion:(1)The rs10983755G/A locus GG genotype can increase the susceptibility to develop cerebral infarction,and the G allele may be an independent risk factor for the development of cerebral infarction.(2)TT genotype at rs10116253T/C locus can increase the susceptibility to develop cerebral infarction,and the T allele may be an independent risk factor for the development of cerebral infarction.(3)Patients with cerebral infarction carrying the rs10983755G/A locus GG genotype were at higher risk of severe neurological deficits and poor prognosis than those carrying the AA genotype,and those carrying the rs10116253T/C locus TT genotype were at higher risk of severe neurological deficits than those carrying the CC genotype.(4)The TT genotype at the rs10116253T/C locus increases the risk of poor prognosis in patients with cerebral infarction,and the T allele may be an independent biological predictor of poor prognosis in cerebral infarction. |
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