不同年龄分期老年AD患者APOE基因表达及其与患者认知功能障碍的关系

APOE Gene Expression in Elderly Patients with AD at Different Age Stages and its Relationship with Cognitive Impairment

目的:探讨不同年龄分期老年阿尔茨海默病(AD)患者载脂蛋白E(APOE)基因表达情况,并分析其与患者认知功能障碍的关系。方法:选择2018年6月至2019年6月我院收治的老年AD患者64例为主要研究对象,根据患者发病年龄分为早发型AD组(<65岁)、迟发型AD组(>65岁),迟发型AD组又分为老年期组(65~80岁)、高龄期组(80~90岁)、长寿期组(>90岁),每组16例。抽取4组患者的外周血,检测其APOE基因表达情况,并用Pearson相关性分析其与患者认知功能障碍间的相关性。结果:4组患者均未出现E2/E2型APOE基因亚型,E3/E3亚型表达中,1组患者的频率最高,为62.50%(10/16),其次为2组患者的43.75%(7/16),E3/E4亚型表达中,三组患者频率最高,为43.75%(7/16),其次为4组患者的37.50%(6/16),其余亚型的表达均较低;APOE共E2、E3、E43种等位基因,其中E3的表达频率最高,其次为E4,E2表达频率最低。4组患者的MMSE、ADAS-cog、ADL评分比较,差异均具有统计学意义(P<0.05),且MMSE评分中:1组>2组>3组>4组,ADAS-cog评分中:1组<2组<3组<4组,ADL评分中:1组<2组<3组<4组,差异均具有统计学意义(P<0.05)。不同APOE基因亚型患者的MMSE评分、ADAS-cog评分、ADL评分比较,差异具有统计学意义(P<0.05),两辆组间LSD-t检验,差异无统计学意义(P>0.05)。结论:不同年龄分期老年AD患者APOE基因表达不同,且其APOE4基因的表达与认知功能障碍密切相关,故临床中可通过调控APOE4基因的表达来延缓AD的发病年龄。

Objective:To investigate the expression of apolipoprotein E(APOE)gene in elderly patients with Alzheimer's disease(AD)at different ages and stages,and to analyze the relationship between APOE gene expression and cognitive impairment.Methods:64 elderly AD patients admitted to our hospital from June 2018 to June 2019 were selected as the main subjects.According to the age of onset,the patients were divided into early-onset AD group(<65 years old)and late-onset AD group(>65 years old).The late-onset AD group was further divided into old-onset group(65-80 years old),old-onset group(80~90 years old)and longevity Group(>90 years old),with 16 cases in each group.The APOE gene expression in peripheral blood of four groups was detected,and the correlation between APOE gene expression and cognitive impairment was analyzed by Pearson correlation.Results:E2/E2 APOE subtypes were not present in all 4 groups.In E3/E3 subtypes,the frequency of group 1 was the highest,62.50%(10/16),followed by 43.75%of the 2 groups(7/16),in the E3/E4 subtype expression,the frequency of the three groups was the highest,43.75%(7/16),followed by 37.50%(6/16)of the 4 groups,and the expression of the other subtypes was lower;APOE There are three E1/E3/E4 alleles,of which E3 has the highest frequency of expression,followed by E4,and E2 has the lowest frequency.The MMSE,ADAS-cog,and ADL scores of the 4 groups were statistically significant(P<0.05),and the MMSE scores were:1 group>2 groups>3 groups>4 groups,and the ADAS-cog score:1 group<2 group<3 group<4 group,ADL score:1 group<2 group<3 group<4 group,the difference was statistically significant(P<0.05).The MMSE score,ADAS-cog score,and ADL score of patients with different APOE genotypes were statistically significant(P<0.05).There was no significant difference in LSD-t test between the two groups(P>0.05).Conclusion:The expression of APOE gene is different in AD patients with different ages,and the expression of APOE4 gene is closely related to cognitive dysfunction.Therefore,the age of AD can be delayed by regulating the expression of APOE4 gene.