急性脑血管病患者ApoE基因多态性临床分布特征及与血脂水平的相关性研究

Clinical Distribution of ApoE Gene Polymorphism in Patients with Acute Cerebrovascular Disease and Its Correlation with Blood Lipids

目的分析急性脑血管病患者ApoE基因多态性的临床分布特征及与血脂的关系。方法采用焦磷酸测序技术对311例急性脑血管病患者ApoE基因多态性进行检测。同时检测三酰甘油(TG)、胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C)。结果共收集2017年3月~2018年2月北部战区总医院住院急性脑血管病患者311例,ApoE各基因型频率为:ε2/ε2型0.03%,ε3/ε3型69.1%,ε4/ε4型1.0%,ε2/ε3型12.9%,ε2/ε4型1.6%和ε3/ε4型15.1%,ApoE表现型分布的频率为:E2占13.2%,E3占70.7%和E4占16.1%。急性脑血管患者ApoE基因型及表现型在男女人群间的分布差异无统计学意义(χ^2=0.37~2.31,均P>0.05),在年龄组间的分布差异无统计学意义(χ^2=3.30~5.08,均P>0.05),在不同临床诊断中的分布差异也无统计学意义(χ^2=0.71~4.54,均P>0.05)。急性脑血管病患者ApoE各基因型在TG,TC,LDL-C和HDL-C浓度水平均差异有统计学意义(F=11.94~19.60,均P<0.05)。急性脑血管病患者ApoE各表现型在TC,HDL-C和LDL-C浓度水平差异有统计学意义(F=6.27~15.59,均P<0.05),但在TG浓度水平差异无统计学意义(F=4.35,均P>0.05)。结论急性脑血管病患者ApoE基因呈多态性分布,其多态性分布与性别、年龄和临床诊断无关。急性脑血管病患者ApoE基因型和表现型与个体血脂水平存在差异性,临床上可针对急性脑血管病患者的个体化治疗方案,选择合适的降脂药物。

Objective To analyze the clinical distribution of ApoE gene polymorphism in patients with acute cerebrovascular disease and its relationship with blood lipids.Methods Pyrosequencing technique was used to detect ApoE gene polymorphism in 311 patients with acute cerebrovascular disease.Meanwhile,triglyceride(TG),cholesterol(TC),high density lipoprotein(HDL-C) and low density lipoprotein(LDL-C) were detected.Results A total of 311 patients with acute cerebrovascular disease were collected from March 2017 to February 2018 in the General Hospital of Northern War Zone.The frequencies of ApoE genotypes were as follows:ε2/ε2 was 0.03%,ε3/ε3 was 69.1%,ε4/ε4 was 1.0%,ε2/ε3 was 12.9%,ε2/ε4 was 1.6% and ε3/ε4 was 15.1%.The frequency of ApoE phenotypes was 13.2% for E2,70.7% for E3 and 16.1% for E4.The distribution of ApoE genotypes and phenotypes in patients with acute cerebrovascular disease had no significant difference between men and women(χ^2=0.37~2.31,all P>0.05),the distribution of ApoE genotypes and phenotypes among age groups had no significant difference(χ^2=3.30~5.08,all P>0.05),and the distribution of ApoE genotypes and phenotypes in different clinical diagnosis had no significant difference(χ^2=0.71~4.54,all P>0.05).There were significant differences in the levels of TG,TC,LDL-C and HDL-C among the genotypes of ApoE in patients with acute cerebrovascular disease(F=11.94~19.60,all P<0.05).The ApoE phenotypes in TC,HDL-C and LDL-C of patients with acute cerebrovascular disease had significant difference(F=6.27~15.59,all P<0.05),but there was no significant difference in the levels of TG(F=4.35,P>0.05).Conclusion ApoE gene was polymorphic in patients with acute cerebrovascular disease.The distribution of ApoE gene polymorphism was not related to gender,age and clinical diagnosis.ApoE genotype and phenotypes in patients with acute cerebrovascular disease were correlated with individual blood lipid level.Clinically,individualized treatment programs for patients with acute cerebrovascular disease can be formulated according to different ApoE genotypes or alleles,and appropriate lipid-lowering drugs can be selected.