3种类型脑梗死患者载脂蛋白E基因多态性分析

Analysis of Apolipoprotein E Gene Polymorphism in Three Kinds of Cerebral Infarction

目的:探讨载脂蛋白E(ApoE)基因多态性与不同类型脑梗死的关系。方法:应用聚合酶链反应-限制性片段长度多态性技术(PCR-RFLP),检测115例脑梗死患者(脑梗死组)和120例健康受试者(对照组)的ApoE基因型和基因频率,并将脑梗死患者分为3种类型:动脉粥样硬化性血栓形成(ACI)69例、心源性脑栓塞8例和腔隙性梗死38例。同时检测研究对象血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)和高密度脂蛋白(HDL)。结果:脑梗死组ε4基因频率显著高于对照组(P<0.05),ε4在ACI患者中频率较高,与腔隙性梗死和对照组相比差异有统计学意义(P<0.05或P<0.01)。在脑梗死患者中,ε2有升高HDL的作用,ε4有升高TG的作用。结论:ApoE ε4是动脉粥样硬化性血栓形成的遗传易感因子。ApoE可能通过引起血脂代谢紊乱而增加脑梗死发病危险性。

Objective： To study the relationship between apolipoprotein E polymorphism and three cerebral infarction subtypes, and to detect the relationship between ApoE alleles and serum lipid levels. Methods： The distribution of allelic and genotypie frequencies of ApoE was analyzed by PCR-RFLP technique in cerebral infarction group （115 cases） and age- and sex-matched control group （120 cases）. Patients with cerebral infarction were divided into three groups which included atherothrombosis, cardioembolism and lacunar infarction groups. The serum levels of lipids were measured. Results： Patients with acute atherosclerotic cerebral infarction （ACI） had a higher ApoE ε4 allele frequency than controls. ACI had a higher ApoE ε4 allele frequency than lacunar infarction. There were significant dyslipidemia associated with ApoE allele in ACI group. As compared with ApoE ε3, ε4 allele was associated with increased serum level of TG, and ε2 allele was associated with increased serum levels of HDL in cerebral infarction group. Conclusion： ApoE ε4 allele is a genetic susceptible factor atherothrombosis. It has no association with lacunar infarction. The effect of ApoE on cerebral infarction may be mediated through dyslipidemia and atherogenesis.