冠心病痰瘀证候与载脂蛋白E基因多态性相关性的研究

Relationship of Phlegm and Blood-stasis Syndrome in Coronary Heart Disease with Gene Polymorphism of Apolipoprotein E

【目的】探讨冠心病(CHD)痰瘀证候与载脂蛋白E(ApoE)血清水平及其基因多态性的关系。【方法】选择符合中医痰瘀证型的CHD患者(CHD组)97例,其中又分为痰证组30例、瘀证组32例、痰瘀证组35例。另选择健康人群35例设为正常对照组。检测所有样本的ApoE血清水平,提取全血DNA,用聚合酶链反应—限制性片段长度多态性(PCR-RFLP)技术检测ApoE基因型,采用SPSS 11.0软件进行相关性分析。【结果】传统危险因素中糖尿病、吸烟、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)等指标CHD组明显高于正常对照组(P<0.05)。CHD组及组内各型的ApoE血清水平均高于正常对照组(P<0.01)。CHD组内各证型间比较,痰瘀证ApoE血清水平明显高于痰证和瘀证(P<0.01),瘀证ApoE血清水平也高于痰证(P<0.05)。CHD组E3/3基因型频率低于正常对照组(P<0.05),而E3/4基因型频率明显高于正常对照组(P<0.01)。CHD组E4等位基因频率高于正常对照组(P<0.05)。痰证的E3/4基因型和E4等位基因频率高于痰瘀证、瘀证(P<0.05),而E3/3基因型及E3等位基因在痰证中的频率低于痰瘀证及瘀证(P<0.05)。【结论】ApoE可能是CHD独立预测因子之一,其血清水平升高与CHD痰瘀证关系密切。ApoE E4等位基因和CHD密切相关,其中E3/4基因型可能是CHD及其痰证的主要易感基因之一。

Objective To explore the relationship of apolipoprotein E（ApoE） and its gene polymorphism with phlegm and blood stasis syndrome in patients with coronary heart disease（CHD）.Methods Ninety-seven qualified CHD patients involving phlegm syndrome（PS）,blood-stasis syndrome（BSS）,and phlegm and blood stasis syndrome（PBSS） were adopted.Thirty-five healthy volunteers were enrolled into the control group.Serum ApoE level was examined in all of the subjects,and their whole blood DNA were extracted for the detection of ApoE gene polymorphism by polymerase chain reaction-restriction fragment length polymorphism（PCR-RFLP）.Correlation analysis of the data was performed with SPSS11.0 software.Results The difference of diabetes mellitus,smoking,low-density lipoprotein cholesterol（LDL-C） and high-density lipoprotein cholesterol（HDL-C） was significant between CHD patients and healthy volunteers（P〈0.05）.The serum ApoE level was higher in CHD patients than that in healthy volunteers,and was higher in CHD patients with PBSS than that in CHD patients with PS and BSS（P〈0.01）.Serum ApoE level was also higher in CHD-BSS patients than that in CHD-PS patients（P〈0.05）.The E4 allele frequency in CHD patients was higher than that in healthy volunteers（P〈0.01）.E3 /3 genotype frequency was lower（P〈0.05） while E3 /4 genotype frequency was higher（P〈0.01） in CHD patients than those in healthy volunteers.Frequency of E3 /4 genotype and E4 allele was higher,while that of E3 /3 genotype and E3 allele was lower in CHD patients with PS than that in CHD patients with PBSS and BS（P〈0.05）.Conclusion ApoE may be one of the independent predictive factors of CHD,and the rise of serum ApoE level has a close relationship with the phlegm and blood stasis syndrome.ApoE E4 allele has a close relationship with CHD,and E3 /4 genotype is possibly one of the principal predisposing genes of CHD and CHD with phlegm syndrome in traditional Chinese medical field.