载脂蛋白E基因ε4与脑外伤预后的相关性研究

Association of APOE- ε4 with Outcome after Truamatic Brain Injury

目的探讨载脂蛋白E基因ε4（APOEε4）与脑外伤预后的相关性。方法采用前瞻性对照研究，利用聚合酶链式反应-限制性片段长度多态性方法对163例脑外伤患者和72例正常人检测其APOE基因型，分析病例组与对照组的基因型和等位基因频率；病例组随访6个月，以G0s评分评定预后，统计APOE基因ε4与脑外伤的伤情和预后的相关系数。结果病例组与对照组的基因型和基因频率分布无显著性差异（P〉0．05）；44例APOEε4患者有18例（41％）预后不良（死亡、植物生存或重度残疾），明显高于非APOEε4患者（25／119，21％，P〈0．05）；经过logistic单因素回归分析，提示APOEε4仍是影响预后的主要因素（OR=3．47，P=0．02，95％CI 1．026～9．528）。结论APOEε4与脑外伤后不良预后有关，提示载脂蛋白E可能在创伤性脑损伤的病理生理过程中起着重要作用。

Objective The mechanism of traumatic brain injury （TBI） is complicated and its genetic factors gradually were concerned. This study tested whether the apoliporotein E gene （APOE ε 4） influences the outcome of traumatic brain injury. Methods 163 cases of traumatic brain injury and 72 health adults were prospectively studied.,and in both groups apolipoprotein E genotype was determined by polymerase chain reaction- restriction fragment length polymorphism （PCR-RFLP）. Six months after injury, patients were determined outcome according to GOS, and association between APOE ε 4 and outcome of TBI were analysed. Results There was no difference of APOE genotype and allele frequency in the TBI group compared with control group （P〉0. 05）. Of the 44 cases, whom were APOE ε 4 carriers, 18（41%） was associated poor outcome（defined as dead, in a vegetative state, or with severe disability） compared with no-carries （25/119, 21%） （P 〈0. 05）.Logistic regression analyses showed that APOE ε 4 was a main factor affected outcome after traumatic brain injury. Conclusion Patients with APOE ε 4 have a relatively poor outcome after traumatic brain injury, which indicates that APOE may play an important role in pathophysiological mechanisms of the human brain to injury.