ApoE基因多态性与脑梗死认知障碍及复发的相关性分析

Correlation of ApoE gene polymorphisms with cognitive disorders and recurrence of cerebral infarction

目的:分析载脂蛋白E(ApoE)基因多态性与脑梗死认知障碍及复发的相关性。方法:选取2018年1月~2019年12月本院收治的78例脑梗死后认知功能障碍患者为观察组,另选取同期本院收治的脑梗死后认知功能正常患者80例作为对照组。收集两组患者的临床资料,检测ApoE基因分型;并对观察组患者随访1年,根据1年内脑梗死复发情况分为复发组、未复发组,对比不同复发情况患者ApoE基因型及等位基因分布情况。结果:2组患者中,最常见的ApoE基因型均为ε3/3(观察组58.97%、对照组63.75%);经比较,观察组的ε4/4基因型频率明显高于对照组。2组患者中,最常见的等位基因均为ε3(观察组70.51%、对照组78.75%),其次是ε4、ε2;经比较,观察组的ε4等位基因频数明显高于对照组。脑梗死患者中,携带ε4等位基因患者的MoCA、MMSE评分均明显低于携带ε2、ε3患者。观察组78例患者均获随访,随访率100%。据统计,有26例患者在为期1年的随访中出现脑梗死复发,复发率33.33%。经比较,复发组和未复发组患者在性别、年龄、合并疾病及文化程度方面均无明显差异,但复发组的ε4等位基因频数明显高于未复发组。结论:ApoE基因多态性与脑梗死认知障碍及复发存在相关性,携带ε4基因可能是脑梗死认知障碍及复发的易感因素。

Objective To analyze the correlation between apolipoprotein E(ApoE)gene polymorphisms and cognitive disorders,recurrence of cerebral infarction.Methods A total of 78 patients with cognitive dysfunction after cerebral infarction who were admitted to the hospital from January 2018 to December 2019 were enrolled as observation group,while another 80 patients with normal cognitive function after cerebral infarction during the same period were enrolled as control group.The clinical data in the two groups were collected to detect ApoE genotypes.The patients in observation group were followed up for 1 year.According to recurrence situations of cerebral infarction within 1 year,they were divided into recurrence group and non-recurrence group.The genotypes and alleles of ApoE among patients with different recurrence situations were compared.Results The most common ApoE genotype wasε3/3 in observation group(58.97%)and control group(63.75%).The frequency ofε4/4 genotype in observation group was significantly higher than that in control group.The most common allele wereε3 in observation group(70.51%)and control group(78.75%),followed byε4 andε2.The frequency ofε4 allele in observation group was significantly higher than that in control group.Among patients with cerebral infarction,scores of Montreal Cognitive Assessment(MoCA)and Mini-mental State Examination(MMSE)in patients withε4 allele were significantly lower than those withε2 andε3.All the 78 patients in observation group were followed up,with follow-up rate of 100%.According to statistics,there were 26 cases(33.33%)with recurrence of cerebral infarction during the 1-year follow-up.There was no significant difference between recurrence group and non-recurrence group in gender,age,diseases or educational level.However,the frequency ofε4 allele in recurrence group was significantly higher than that in non-recurrence group.Conclusion The polymorphisms of ApoE gene are related with cognitive dysfunction and recurrence of cerebral infarction.Theε4 gene may be a susceptible factor for cognitive disorders and recurrence of cerebral infarction.