冠心病患者载脂蛋白E基因多态性的临床意义

Significance of apolipoprotein E gene polymorphism in patients with coronary heart disease.

目的探讨载脂蛋白E(ApoE)基因多态性对冠心病发病的意义。方法选择98例冠心病患者(CHD组)及87例非冠心病患者(均通过冠脉造影证实)。采用生物化学方法测定其血清血脂,应用聚合酶链反应(PCR)-限制性片段长度多态性分析(RFLP)法,以Hhal内切酶及聚丙烯酰胺凝胶电泳确定ApoE基因多态性。结果冠心病组ApoE4/3基因型及ε4等位基因频率都比对照组高,差异有显著性(P<0.05);冠心病组高脂血症例数要高于对照组(P<0.05);两组中含ε4等位基因者TC、LDL水平较E3型者高(P<0.05),差别有显著性。结论E4等位基因是影响血清TC、LDL-C水平的重要遗传因素之一,并进一步导致冠状动脉粥样硬化及冠心病的发生,是CHD发病的重要危险因素。

Objective To study the influence of apolipoprotein E polymorphism on the occurrence of coronary heart disease （CHD）. Methods Ninety- eight cases and eighty- seven control subjects confirmed through coronary artery angiography were enrolled and their plasma levels of triglyceride （TG）, total cholesterol （TC）, low density lipoprotein cholesterol （LDL- C） and high density lipoprotein cholesterol （HDL- C） were determined. Polymorphism of apolipoprotein E alleles were measured by polymerase chain reaction （PCR）, restriction fragment length polymorphism （RFLP）, Objective Hha endonuclease digestion and polyacrylamideg electrophoresis. Results There were significant differences in gene frequency of ApoE between CHD and control group. ApoE3/4 genetype and E4 allele frequency in CHD group were higher than those in control group. TC and LDL levels of CHD group were higher than control （ P 〈 0.05）. Conclusion ApoE3/4 genotypes and E4 allele are some of the hereditary factors which effect the level of serum TC, LDL - C, and furthuremore lead the occurrence of coronary atherosclerosis and CHD. ApoE4 may be an independent genetic risk factor in subjects predisposed to CHD.