载脂蛋白E等位基因4与缺血性脑血管病患者记忆障碍的关系

Relationship Between ApoEε4 and the Memory Impairment in Inpatients with Ischemic Cerebrovascular Diseases

目的探讨缺血性脑血管病(ischemic cerebral vascular disease,ICVD)患者记忆障碍与载脂蛋白E等位基因4(apolipoprotein Eε4,apoEε4)的关系,为进一步提出血管性认知损害的早期预测指标提供参考依据。方法对新桥医院同期收集的70例ICVD患者和70例健康对照,进行神经心理学量表评定及apoEε4基因检测。结果ICVD组携带apoEε4的基因数目显著高于对照组(P<0.01)。携带ε4的正常对照受试者记忆商评分显著低于未携带ε4的对照受试者(P<0.05),且ε4与记忆商得分存在负相关(OR=-0.297,P<0.05)。携带ε4的ICVD患者MMSE得分显著低于未携带ε4的患者(P<0.01),ε4与MMSE得分存在负相关(OR=-0.541,P<0.01);携带ε4的ICVD患者记忆商得分显著低于未携带ε4的患者(P<0.01),ε4与记忆商得分存在负相关(OR=-0.425,P<0.01)。脑梗死患者记忆功能减退相关的危险因素进行多元回归分析,仅是否携带ε4一个危险因素被纳入回归方程。结论apoEε4是导致缺血性脑血管病患者记忆功能损害的危险因素。

Objective This study is to investigate the characteristics of memorial impairment in patients with ICVD and the correlation with apoEε4 for support by the evidences of VCI diagnostic criteria and the laboratory indexes in the early period. Methods Seventy patients with ICVD and seventy senile volunteers, who came from the same hospital in the same period were enrolled in the study. They were examined with neuropsychological tests and detected the apoEε-4 gene. Results The ICVD group had higher allele frequencie in genetype of apoEε4 compared with the control group （ P 〈 0. 01 ）. The ε4 ＋ control group had lower scores in MQ compared with the control ε4 - group and they displayed an inverse correlation （ OR = - 0. 297, P 〈 0.05）. The ε4 ＋ ICVD group had lower scores in MMSE compared with the control ε4 - group and they displayed an inverse correlation （ OR = - 0. 541, P 〈 0.01 ）, the ε4 ＋ ICVD group had lower scores in MQ compared with the control ε4 - group and they displayed an inverse correlation （ OR = - 0. 425, P 〈0. 01 ）. Multiple regression analysis showed the most risky factors in CI is having ε4, the orther risky factors was excluded. Conclusions ApoEε4 is an risky factor of memory dysfunction in the patients with ICVD.