Department of Neurology, People's Hospital of Deyang City.
Department of Neurology, the Third Affiliated Hospital of Wenzhou Medical University.
J Atheroscler Thromb. 2017 Dec 1;24(12):1258-1266. doi: 10.5551/jat.41145. Epub 2017 Aug 24.
To investigatethe association of plasma epoxyeicosatrienoic acids (EETs) with early neurologic deterioration (END), and whether EETs are mediated by EPHX2 variants in patients with minor ischemic stroke (MIS).
This was a prospective, multi-center observational study in patients with acute MIS in the Chinese population.Plasma EETs levels were measured on admission. Single nucleotide polymorphisms (SNPs) of EPHX2 rs751141 were genotyped using mass spectrometry. The primary outcome was END within 10 days after admission. END was defined as an increase in NIHSS of 2 or more points. The degree of disability was assessed using the modified Rankin Scale (mRS) at 3 months after admission.
A total of 322 patients were enrolled, of which 85 patients (26.4%) experienced END. The mean EETs level was 64.1±7.5 nmol/L. EETs levels were significantly lower in patients with END compared to patients without END. Frequency of EPHX2 rs751141 GG was higher in patients with END than in patients without END, and EPHX2 rs751141 GG genotype was associated with lower EETs levels. Low level (＜64.4 nmol/L) of EETs was an independent predictor of END (first and second quartiles) in multivariate analyses. END was associated with a higher risk of poor outcome (mRS scores 3-6) at 3 months.
END is fairly common and associated with poor outcomes in acute MIS. EPHX2 variants may mediate EETs levels, and low levels of EETs may be a predictor for END in acute MIS.
探讨血浆环氧二十碳三烯酸（EETs）与早期神经功能恶化（END）的关系，以及 EETs 是否受 EPHX2 变异体在小缺血性卒中（MIS）患者中的调节。
这是一项在中国人群中急性 MIS 患者的前瞻性、多中心观察性研究。入院时测定血浆 EETs 水平。采用质谱法对 EPHX2 rs751141 的单核苷酸多态性（SNP）进行基因分型。主要结局为入院后 10 天内的 END。END 定义为 NIHSS 增加 2 分或以上。入院后 3 个月采用改良 Rankin 量表（mRS）评估残疾程度。
共纳入 322 例患者，其中 85 例（26.4%）发生 END。EETs 水平的平均值为 64.1±7.5 nmol/L。与无 END 患者相比，END 患者的 EETs 水平明显降低。与无 END 患者相比，END 患者 EPHX2 rs751141 GG 频率更高，EPHX2 rs751141 GG 基因型与 EETs 水平降低相关。在多变量分析中，EETs 水平低（＜64.4 nmol/L）是 END（第一和第二四分位数）的独立预测因子。END 与 3 个月时不良结局（mRS 评分 3-6）的风险增加相关。
END 在急性 MIS 中较为常见，与不良结局相关。EPHX2 变异体可能调节 EETs 水平，EETs 水平低可能是急性 MIS 中 END 的预测因子。
