老年人冠心病与缺血性脑卒中载脂蛋白E基因多态性对比研究

Comparative Study on Apolipoprotein E Gene Polymorphisms between Coronary Heart Disease and Ischemic Stroke in the Elderly

目的探讨老年人冠心病与缺血性脑卒中载脂蛋白E(ApoE)基因分布及其与临床类型的关系。方法 >60岁的冠心病患者68例(急性心肌梗死38例、不稳定型心绞痛30例)和>60岁的缺血性脑卒中患者61例(脑梗死30例、短暂性脑缺血发作31例),健康人156例为对照组,采用PCR进行ApoE基因分型。结果 3组ApoE基因型分布及等位基因频率比较,差异有统计学意义(P<0.05);冠心病组及缺血性脑卒中组各基因型及等位基因频率比较,差异无统计学意义(P>0.05);正常对照组ApoEε3为优势基因,冠心病组及缺血性脑卒中组ApoEε4基因频率及等位基因频率均较对照组高(P<0.05);急性心肌梗死、不稳定型心绞痛、脑梗死、短暂性脑缺血发作4组ApoEε4基因阳性率比较,差异无统计学意义(P>0.05)。结论 ApoEε4(+)是老年人冠心病与缺血性脑卒中共同危险因素,其机理可能与ApoEε4阳性促进动脉粥样硬化有关。

Objective To explore the distribution of apolipoprotein E （ApoE） gene and its clinical types in the elderly with ischemic stroke or coronary heart disease （CHD）. Methods Sixty eight CHD patients aged 60 years and over（ CHD group） including 38 cases of acute myocardial infarction and 30 cases of unstable angina pectoris,and sixty one patients with ischemic stroke（IS） aged 60 years and over（IS group） including 30 cases of cerebral infarction and 31 cases of transient ischemic attack were enrolled in the study,156 normal in the control group. PCR was applied to classify ApoE gene. Results The distribution of ApoE gene and the allele frequency showed significant difference among three groups （P 〈 0.05 ）, but did not showed significant difference between CHD group and IS group （P 〉 0.05）. ApoEε3 was the dominate gene in the control group,the frequencies of ApoEε4 gene and allele were higher in the CHD group and IS group than those in the control group （ P 〈 0.05 ）. There was no significant difference in positive rate of ApoEε4 gene among four groups including patients with acute myocardial infarction, unstable angina pectoris, cerebral infarction and transient ischemic attack （P 〉 0.05）. Conclusion ApoEε4 （ ＋ ） is the shared risk factor of CHD and IS in the elderly,its mechanism might be correlated to atherosclerosis induced by ApoEε4 （ ＋ ）.