血液透析患者ApoE基因多态性与左心室肥厚的关系

Relationship between apolipoprotein E gene polymorphism and left ventricular hypertrophy in hemodialysis patients

目的探讨血液透析患者载脂蛋白E(ApoE)基因多态性与左心室肥厚(LVH)的关系。方法选择164例维持性血液透析(MHD)患者,并以同期健康者290例为对照。测量左心室重量指数(LVMI),判断MHD患者LVH的发生率。采用聚合酶链式反应限制性片断长度多态性技术(PCR-RFLP)对所有MHD患者和健康者进行ApoE基因多态性检测。除ε2/4基因型外,剩余基因型分成3组:ε2/2+ε2/3、ε3/4+ε4/4及ε3/3,分析ApoE基因多态性与LVH的关系。检测3组ApoE基因型MHD患者血脂水平并统计高血压的发生率。结果 MHD患者和健康者6种ApoE基因型和3种等位基因的构成比比较差异均无统计学意义(P>0.05)。MHD患者中LVH的发生率为64.0%。含等位基因ε4(ε3/4+ε4/4)的MHD患者LVH的发生率高于含等位基因ε2(ε2/2+ε2/3)及ε3(ε3/3)的患者(P<0.01)。含等位基因ε4的MHD患者血清TC、LDL-C、TG水平和高血压发病率亦高于含等位基因ε2及ε3的患者(P<0.05)。结论含ApoE等位基因ε4的MHD患者更易发生LVH。

Objective To observe the relationship between apolipoprotein E（ApoE）gene polymorphism and left ventricular hypertrophy（LVH）in hemodialysis patients.Methods A total of 164 hemodialysis patients and 290 controls were included.The left ventricular mass index（LVMI）of all hemodialysis patients were measured.The incidence of LVH in hemodialysis patients was determined according to LVMI.ApoE gene polymorphism of hemodialysis patients and controls was detected by the polymerase chain reaction restriction fragment length polymorphism（PCR-RFLP）.The hemodialysis patients were divided into three groups according to ApoE gene genotype.The relationship between ApoE gene polymorphism and left ventricular hypertrophy in hemodialysis patients was analysed.The levels of blood lipids were detected and the incidence of hypertension was calculated in three groups of hemodialysis patients.Results There were no statistical differences between controls and hemodialysis patients in the numbers of six ApoE genotypes and the incidence of three alleles.The incidence of LVH was 64.0%in hemodialysis patients.The incidence of LVH in patients with ApoE alleleε4was higher significantly than others.The levels of TC,TG,LDL-C and the incidence of hypertension in patients with ApoE alleleε4were higher than others,too.ConclusionThe ApoE alleleε4can be regarded as an important risk factor for LVH in hemodialysis patients.