卒中后抑郁患者认知功能与ApoE基因多态性的关联研究

Association study on cognitive function and apoliporotein E gene polymorphism in poststroke depression patients

目的探讨卒中后抑郁患者（post-strokedepression，PSD）认知功能损害与ApoE基因多态性之间的相关性。方法根据24项汉密尔顿抑郁量表（HAMD-24）评分将患者分为PSD组（83例）和卒中组（96例），选取健康志愿者（53例）作为对照组。采用事件相关电位（ERP）P300作为认知功能的评定指标。采用基因测序法测定载脂蛋白E基因第四外显子112位（rs429358）和158位（rs7412）单核苷酸位点多态性。结果1．EPR测定卒中后抑郁组N2、P3波潜伏期较卒中组和对照组延长，P3波幅降低，差异有统计学意义（P〈0．05）。2．PSD组ε3／ε4基因型频数（24例）高于对照组（7例），ε4／4基因频数（8例）高于卒中组（2例），差异有统计学意义（P〈0．05）；ε4等位基因频率（24．7％）高于卒中组（16．1％）和对照组（9．4％），差异有统计学意义（P〈0．05）。3．PSD组携带ε4等位基因的HAMD-24评分、N2潜伏期、P3潜伏期高于非携带ε4等位基因组，差异有统计学意义（P〈0．05）。结论PSD患者存在认知功能损害，ε4等位基因可能与PSD患者的认知功能损害和抑郁情绪具有一定相关性。

Objective To study and analyze the relation between cognitive impairment and apolipoprotein E （ApoE） gene polymorphism in post-stroke depression patients（PSD）. Methods The patients were divided into PSD group（ 83 cases ） and brain stroke group（ 96 cases ） by using the 24-item Hamilton Depression Rating Scale （HAMD-24） , and healthy volunteers were selected as a control group（53 cases）. Cognitive function was evaluated by using the event-related potential （ERP） P300 and single nucleotide polymorphisms of ApoE exon 4 of 112 （rs429358） and 158 （rs7412） were determined by using gene sequencing method. Results 1. Compared with the brain stroke group and the control group, latency in ERP including N2 and P3 of PSD group was significantly prolonged （P〈 0.05 ） , while the amplitude of P3 in PSD was significantly lower（P〈 0.05 ）. 2. ε3/ε4 genotype frequency in PSD group（24 cases） was significantly higher than that in the control group（7 cases） （P〈0.05）. The ε4/4 genotype frequency in PSD group （8 cases） was significantly higher than that in brain stroke group （2 cases） （P 〈 0.05 ）. The ε4 allele rate in PSD group （24.7%） was significantly higher than that in both brain stroke group （16.1% ）and control group（ 9.4% ） （all P 〈 0.05 ）. 3. The PSD patients with ε4 allele had significantly higher score of HAMD-24 and prolonged latency of N2 and P3 than those without e4 allele （P 〈 0. 05 ）. Conclusion There is cognitive impairment in PSD patients. The ApoE ε4 allele may associate with the cognitive impairment and depression in PSD patients.