老年冠心病患者载脂蛋白E基因多态性检测的临床意义

The clinical significance of the detection of apolipoprotein E polymorphism for coronary heart disease in the elderly

目的 探讨载脂蛋白E(apoE)基因多态性与老年冠心病的关系及其对血脂、脂蛋白水平的影响。 方法 应用聚合酶链反应 限制性片段长度多态性法 (PCR RFLP)检测 12 5例老年冠心病患者和 116例健康老年人 (对照组 )的apoE基因型 ;按常规方法测定血浆脂质、脂蛋白水平。 结果 冠心病组及对照组共检出 6种基因型 ,分别为 :E2 / 2、E2 / 3、E3/ 3、E3/ 4、E4 / 4、E2 / 4 ;冠心病组E3/ 3基因型频率 (5 1 2 % )和ε3等位基因频率 (73 2 % )明显低于对照组 (6 9 8%和 84 0 % ,P <0 0 5 ) ;E3/ 4基因型频率 (30 4 % )和ε4等位基因频率 (17 6 % )明显高于对照组 (11 2 %和 6 9% ,P <0 0 5 ) ;冠心病组总胆固醇 (TC)、低密度脂蛋白 胆固醇 (LDL C)水平明显高于对照组 (P <0 0 5 ) ;冠心病患者中E2 / 3、E3/ 3、E3/ 4基因型之间TC、LDL C水平差异有显著性 (P <0 0 5 )。 结论 ε4等位基因是冠心病重要的遗传标记 ;

Objective To study the relationship between apolipoprotein E(apoE) gene polymorphism and coronary heart disease and the effect of apoE gene polymorphism on plasma lipid and lipoprotein levels. Methods Polymerase chain reaction restriction fragment length polymorphism(PCR RFLP) were used for the detection of apoE genotype in 125 elderly patients with coronary heart disease and 116 elderly healthy controls. The plasma lipid and lipoprotein levels were measured by routine method. Results Six genotypes of apoE E2/2, E2/3, E3/3, E3/4, E4/4 and E2/4 were detected in both groups. There were statistically significant differences in apoE3/3 and ε3 allele frequencies( P <0 05) and in apoE3/4 and ε4 allele frequencies( P <0 05) between the patients and controls; plasma total cholesterol(TC) and low density lipoprotein cholesterol(LDL C) of the patients with coronary heart disease were significantly higher than those of the controls( P <0 05). Among different apoE genotypes (E2/3, E3/3, E3/4) of patients with coronary heart disease, there were statistically differences in TC and LDL C levels( P <0 05). Conclusions ApoE ε4 allele is an important genetic marker, apoE gene polymorphism may affect coronary heart disease through plasma lipid and lipoprotein levels.