ApoE基因多态性和血清亲环素A对高血压脑出血患者认知功能的影响

Effect of ApoE gene polymorphism and serum cyclophilin A on cognitive function in patients with hypertensive intracerebral hemorrhage

目的探讨载脂蛋白E基因(ApoE)多态性和血清亲环素A对高血压脑出血患者认知功能的影响。方法选取2015-07—2018-08于许昌市中心医院接受治疗的136例高血压脑出血患者为研究对象,采用蒙特利尔认知量表进行评估并根据结果分为2组,认知评分<26分的88例患者为认知障碍组,认知评分≥26分的48例患者为非认知障碍组。观察2组患者的基因分布情况,并进行多因素分析。结果认知障碍组的3/4基因型和ε4等位基因占比分别为25%、21.59%,相比非认知障碍组的8.33%、8.33%明显增加,差异有统计学意义(P<0.05)。认知障碍组的3/3基因型和ε3等位基因占比分别为48.86%、67.61%则相比非认知障碍组的77.08%、85.42%明显减少,差异有统计学意义(P<0.05)。2组患者的受教育年限、糖尿病发生率、吸烟率比较差异无统计学意义(P>0.05)。认知障碍组高血脂率、血清亲环素A>180占比分别为71.59%、80.68%,相比非认知障碍组的47.92%、31.25%明显增加(P<0.05)。血清亲环素A浓度上升和携带ε4等位基因可增加认知功能障碍的发生风险(OR=2.942/3.522,P=0.009/0.019)。结论血清亲环素A水平的上升和ε4等位基因携带促进了高血压脑出血患者出现认知功能障碍风险,对于病情进展也具有促进作用,二者是影响高血压脑出血患者发生认知功能障碍的独立危险因素,临床前期应注重对血清亲环素A和ε4等位基因的检测,能够为早期诊断提供部分依据。

Objective To explore the effect of ApoE gene polymorphism and serum cyclophilin A on cognitive function in patients with hypertensive intracerebral hemorrhage.Methods Totally 136 patients with hypertensive intracerebral hemorrhage who were treated in our hospital from June 2015 to July 2018 were enrolled in the study.The Montreal cognitive scale was used to evaluate the two groups of patients and the patients were divided into two groups according to the results.Patients with cognitive scores <26 were cognitive control groups,and 48 patients with cognitive scores ≥26 were non-cognitive disorders.The gene distribution of the two groups of patients was observed and compared,and multivariate logistic regression analysis was performed on the factors that may affect the cognitive impairment in patients with hypertensive intracerebral hemorrhage.Results The proportion of 3/4 genotype and s4 allele in the cognitive impairment group were respectively 25% and 21.59%,which significantly higher than 8.33% and 8.33%in the non-cognitive disorder group,and the data were statistically significant(P<0.05).The proportion of 3/3 genotype and ε3 allele in the cognitive impairment group was respectively 48.86% and 67.61 %,which significantly lower than 77.08% and 85.42% in the non-cognitive disorder group,and the data were statistically significant(P <0.05).The results showed that there was no significant difference in the years of education,diabetes incidence,and smoking rate between the two groups.The data were not statistically significant(P> 0.05).The high blood lipid rate and serum cyclophilin A>180 ratio in the cognitive impairment group were respectively 71.59% and 80.68%,which significantly higher than 47.92% and 31.25% in the non-cognitive disorder group,and the data were statistically significant(P <0.05).The results showed that elevated serum cyclophilin A concentration and carrying the s4 allele were independent risk factors for cognitive dysfunction in patients with hypertensive intracerebral hemorrhage(OR=2.942/3.522,P=0.009/0.019).Conclusion Increased serum cyclophilin A level and ε4 allele carrying promote the risk of cognitive dysfunction in patients with hypertensive intracerebral hemorrhage,and also promote the progression of the disease,both of which affect cognitive dysfunction in patients with hypertensive intracerebral hemorrhage Independent risk factors,clinical medical staff should pay attention to the detection of serum cyclophilin A and ε4 alleles in the early stage,which can provide partial basis for early diagnosis.