Alzheimer病和血管性痴呆患者APOE及LRP基因多态性与认知及精神行为症状相关性研究

APOE and LRP gene polymorphisms are associated with clinical symptoms in patients with dementia

目的探讨Alzheimer病(AD)和血管性痴呆(VD)患者APOE及LRP基因多态性与认知及精神行为症状(BPSD)的相关性。方法收集AD患者79例、VD患者85例和健康对照者(对照组)156名,采用简易精神状态检查量表(MMSE)评定认知功能;采用简明精神病量表和汉密尔顿抑郁(HAMD)、焦虑量表(HAMA)评定BPSD。采用PCR-RFLP进行APOEε、LRP基因分型。结果 (1)AD组(17.7%)及VD组(20.5%)APOEε4等位基因频率均高于对照组(5.7%,均P<0.01)。(2)AD组和VD组APOEε4携带者MMSE得分均低于同组APOEε4非携带者〔AD组(13.84±2.32)分vs.(14.78±2.54)分,P<0.01;VD组(15.53±1.87)分vs.(18.45±2.23)分,P<0.01〕。(3)AD组患者APOEε4携带者BPSD比例明显高于APOEε4非携带者(55.56%vs.52.83%,P=0.039)。结论 APOEε4可能是AD、VD患者认知障碍的共同危险因素。APOEε4可能是AD的BPSD危险因素。

Objective To explore the association among APOE, LRP gene polymorphisms and dementia. Cognitive function, behavioral and psychological symptoms of dementia （BPSD） in patients with Alzheimer＇ s disease （AD） and vascular dementia （VD） were studied. Methods Seventy-nine patients with AD, 85 patients with VD, and 156 subjects without dementia as control group were included in the study. All the subjects were recruited from outpatients and inpatients. The cognitive function was assessed by the Mini-Mental State Examination （MMSE）. BPSD were assessed by the Brief Psychiatric Rating Scale （BPRS）, the Hamilton Depression Rating Scale （HAM-D）, and Hamilton Anxiety Rating Scale （HAM-A）. The genotyping was tested by polymerase chain reaction-restriction fragment length polymorphism （PCR-RFLP） methods. Results （1） APOEε4 allele frequencies were higher in both AD and VD group compared with the control group （AD： 17.7% vs. 5.7%, P〈0. 01; VD： 20.5% vs. 5.7%, P〈0. 01）. （2） In both AD and VD group, APOEt4 carriers had a lower MMSE score compared with APOEt4 non-carriers （AD： 13.84±2.32 vs. 14.78±2.54, P〈0.01; VD： 15. 53±1.87 vs. 18.45±2.23, P〈0.01）. （3） In the AD group, the proportion of patients who had BPSD were higher in the APOEt4 carriers group compared with the APOEε4 non-carriers group （55. 560/00 vs. 52.83%, P= 0. 039）. Conclusions ApoEε4 is a common risk factor for cognitive impairment in the patients with AD and VD. ApoEε4 is a risk factor for BPSD in patients with AD.