颅脑创伤在载脂蛋白E基因影响脑电活动中的诱发作用

Isoform-specific influence of APOE induced by traumatic brain injury on the electrical activity of brain

目的探讨颅脑创伤是否在载脂蛋白E基因(apolipoprotein E,APOE)对脑电活动的影响当中起诱发作用。方法收集118例轻-中型创伤性脑损伤患者的临床资料和40例正常成人的相关信息,采用聚合酶链反应限制性片段长度多态性法(PCR-RFLP)检测APOE基因型。在伤后1～3 d,对所有创伤性脑损伤患者进行脑电图检测;在清醒、安静、闭目、血糖正常状态下对所有正常成人进行脑电图检测;采集所有研究对象的定量脑电数据。结果40例正常成人中,APOEε2、APOEε3、APOEε4基因型之间定量数据差异均无统计学意义(P=0.097);118例创伤性脑损伤患者中,脑电活动在APOEε2、APOEε3、APOEε4基因型之间差异有统计学意义(P=0.008);与APOEε3携带者比较,APOEε4携带者的慢活动明显增多,而APOEε2携带者的慢活动相对减少。结论携带不同APOE基因的正常成人脑电活动无差异;在颅脑创伤的诱发下,APOE对脑电活动的影响则表现出亚型特异性;APOEε4对颅脑创伤后的脑电活动带来负面影响,APOEε2则对创伤后的脑功能具有保护作用。

Objective To investigate whether the isoform-specific influence of apolipoprotein E gene（APOE） on the electrical activity of brain is induced by traumatic brain injury（TBI）.Methods The clinical data of 118 patients with mild/moderate traumatic brain injury and 40 normal subjects for control were collected,and the APOE genotyping was performed by means of PCR-RFLP.The electrical activity of brain in every patient was recorded by electroencephalogramy within 3 d after injury and all the subjects for control were examined by electroencephalogramy under conscious,calm,eyes-closed and normoglycemic condition.Quantitative data of every electroencephalogram were collected.Results The quantitative data among APOEε2,APOEε3 and APOEε4 groups of normal subjects had no statistic difference（P=0.097）.In 118 patients with mild/moderate TBI,the quantitative data among APOEε2,APOEε3 and APOEε4 groups had significant difference（P=0.008）.Compared with APOEε3 group,the energy value of slow waves was more in the APOEε4 group and less in APOEε2 group.Conclusion In normal adults,the electrical activity of brain is not significantly different among the three APOE groups.However,under the provocation of traumatic brain injury,the electrical activity of brain in the three groups shows different.After traumatic brain injury,APOEε4 is bad for the electrical activity of brain but APOEε2 protects brain function.