Objective: To comprehensively explore the relationship between proprotein convertase subtilisin/kexin type 9(PCSK9) gene polymorphism detection and the risk of acute ischemic stroke and the lipid-lowering effect of atorvastatin. Methods: A total of 119 patients with acute ischemic stroke(AIS) admitted to the Department of Neurology of our hospital from June 2018 to July 2020 were selected as research subjects, who received atorvastatin calcium tablets 20 mg once a day for 3 months. One hundred and twenty healthy subjects without heart and brain diseases during the same period were selected as control group. The distribution of PCSK9 genotype and allele was compared between the control group and the AIS group. And the levels of triglyceride(TG), total cholesterol(TC), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), apolipoprotein A1(ApoA1), apolipoprotein B(ApoB) and serum PCSK9 were compared between the two groups before and after treatment in patients with different rs562556 genotypes of AIS. Results: There were statistically significant differences in the genotype and allele distribution of SNP1(rs562556), SNP2(rs2479408) and SNP3(rs529787) between the control group and AIS group(P<0.05), and the allele frequencies of A and C in AIS group were higher than those in the control group(P<0.05). Multivariate Logistic regression analysis showed that rs562556 gene polymorphism distribution was all related to the risk of AIS(P<0.05). After treatment, the levels of TC, TG, LDL-C and ApoB in AIS patients with different rs562556 genotypes in the two groups were decreased compared with those before treatment, while serum PCSK9 levels were increased(P<0.05). In addition, the decrease degree of serum TC, TG, LDL-C levels and the increase degree of serum PCSK9 levels in AG+AA group after treatment were higher than those in GG group(P<0.05). Conclusion: The rs562556 dominant gene model(GG vs Ag+AA) can increase the risk of AIS in Han population, which may be an important factor affecting the lipid-lowering effect of atorvastatin in AIS patients. The serum PCSK9 level of patients carrying A allele is significantly increased after atorvastatin treatment, which has a certain negative effect on the lipid-lowering efficiency. |
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