心脑血管疾病患者载脂蛋白基因多态性与血脂、载脂蛋白水平的相关性研究

Correlation of Apolipoprotein Gene Polymorphisms with Blood Lipids and Apolipoprotein Levels in Patients with Cardiovascular and Cerebrovascular Diseases

目的:分析心脑血管疾病患者载脂蛋白基因多态性与血脂、载脂蛋白的相关性,研究载脂蛋白E (ApoE)在心血管疾病发生发展中的作用。方法:选取2017年9月—2019年8月徐州市第一人民医院就诊的500例心脑血管疾病(CVD)患者为实验组,另选取106例健康体检者为对照组,应用PCR-荧光探针法检测ApoE基因型,常规方法检测血脂[甘油三酯(TG),血清总胆固醇(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)]以及载脂蛋白A (APoA)、载脂蛋白B (APoB)、脱脂转化酶(Lpa)、载脂蛋白E (ApoE)水平,比较两组受试者ApoE基因频率差异,将心脑血管疾病患者分为E2、E3、E4组,比较不同ApoE基因型患者血脂及载脂蛋白水平,进一步按照疾病类型对患者进行分组,比较不同类型心血管疾病ApoE基因频率以及血脂水平,分析ApoE在心血管疾病发生发展中的作用。结果:500例心血管疾病患者ApoE等位基因E2型占11.20%,E4型占21.40%,E3型频率最高,占73.30%,与健康体检者相比,差异有统计学意义(t=57.12,P<0.05);将心脑血管疾病患者分为E2、E3、E4组,发现与E2组相比较,E3组E4组TC、LDL、APoB、Lpa水平明显升高,Apo-E水平显著降低,E3组APoA水平明显降低,差异有统计学意义(t=12.58、24.29、35.84、8.28,P<0.05),E3组与E4组血清血脂及载脂蛋白,差异无统计学意义(t=1.95、2.15,P>0.05);进一步按照疾病类型对患者进行分组比较,发现各组间ApoE基因频率、血脂、载脂蛋白水平均无明显差异。结论:心脑血管疾病患者其ApoE基因多态性与血脂水平存在相关性,ApoE在心血管疾病发生发展中发挥一定的作用。

Abastract Objective:To analyze the correlation between apolipoprotein gene polymorphisms and blood lipids and apolipoproteins in patients with cardiovascular diseases and to study the role of apolipoprotein E(ApoE) in the development of cardiovascular diseases.Methods:500 patients with cardiovascular and cerebrovascular disease(CVD) attending hospitals from September 2017to August 2019 were selected as the experimental group, and another 106 healthy physical examiners were selected as the control group. ApoE genotype was detected by PCR-fluorescent probe method, and lipid(triglyceride [TG], total serum cholesterol [TG],high-density lipoprotein [HDL], low-density lipoprotein [LDL]) and apolipoprotein A(APoA), apolipoprotein B(APoB), delipid convertase(Lpa), and apolipoprotein E(ApoE) levels were measured by conventional methods. Differences in ApoE gene frequencies were compared between the two groups of subjects. Patients with cardiovascular disease were divided into E2, E3, and E4 groups,and lipid and apolipoprotein levels were compared among patients with different ApoE genotypes. Patients were further grouped according to disease type, ApoE gene frequencies in different types of cardiovascular disease and lipid levels were compared, and the role of ApoE in the development of cardiovascular disease was analyzed.Results:The ApoE allele E2 type accounted for 11.20%,E4 type accounted for 21.40%, and E3 type had the highest frequency of 73.30% in 500 patients with cardiovascular disease, compared with healthy physical examiners, the difference was statistically significant(t=57.12, P<0.05). Patients with cardiovascular diseases were divided into E2, E3 and E4 groups, and it was found that compared with E2 group, TC, LDL, APoB and Lpa levels were significantly higher and Apo-E levels were significantly lower in E3 group E4 group, and APo A levels were significantly lower in E3 group, and the difference was statistically significant(t=12.58, 24.29, 35.84, 8.28, P<0.05). There was no statistically significant difference in serum lipids and apolipoproteins between the E3 and E4 groups(t=1.95, 2.15, P>0.05). Further comparison of patients grouped by disease type revealed no significant differences in ApoE gene frequency, lipids, or apolipoprotein levels between the groups.Conclusion:There is a correlation between ApoE gene polymorphisms and lipid levels in patients with cardiovascular disease, and ApoE plays a role in the development of cardiovascular disease.