心肌梗死患者及其同胞者血脂水平和ApoE基因分析

Analysis for the level of lipidemia and ApoE gene among myocardial infarction patients and their siblings

目的 研究心肌梗死 (MI)者及其同胞的血脂水平和ApoE基因多态性 ,评价他们之间的关系。方法 对MI患者 6 5例 ,MI患者的健康同胞 14 1例 ,健康对照者 4 7例 ,分别检测其血脂 (TC、LDL C、HDL C和TG)水平及ApoE基因多态性 ,结果进行统计学分析。结果 ①TC、TG、LDL C和TC/HDL C水平MI组及同胞组均高于正常对照组 ,HDL C则MI组明显低于正常对照组 ,以上差异有显著性意义 (P <0 .0 0 1) ;②与血脂异常相关的ApoE基因 3种基因型中以E3/ 3型多见 ,但ApoE基因频率与等位基因频率 3组间差异无显著性意义 ,E4等位基因分布频率很低 ,但MI组中其携带者较对照组有升高趋势 ,E4等位基因携带者早发MI频率的为非E4等位基因携带者的 2倍 ;③非条件Logistic回归建立的血脂及ApoE危险因素指标与MI的相关性为 :TC >5 .2mmol/L、TG >2 .2 6mmol/L、LDL C >3.4mmol/L、TC/HDL C >5 .0为MI危险因素 ,HDL C >0 .9mmol/L为MI的保护因素。结论 血脂代谢紊乱是冠心病和MI的重要易患因素 ,MI及其同胞者血脂水平升高 ,ApoE基因多态性可能是促使冠心病和MI发生的遗传因素。

Objective\ To study the level of lipidemia and the polymorphism of the gene Apoliprotein E(ApoE) genotype among myocardial infarction(MI) and the siblings,and assess the relationship between them.Methods Clinical examinations of lipidemia (TC,LDL-C,HDL-C and TG) and the polymorphism of the gene ApoE genotype were conducted to 65 MI patients,141 healthy siblings of MI patients and 47 healthy persons.The results were done with the statistical analysis.Results ①The level of TC,TG,LDL-C,TC/HDL-C in MI group and sibings group were higher than those in the control group,while the level of HDL/C in MI group was lower than those in the control group with statistical significance( P <0.001).②Among the three genotypes of ApoE,E3/3 was the commonest one,but no significant diffirence was found in the distribution frequencies in the three groups.The distribution frequency of allele E4 was very low,but that of the carrier of MI patients was higher than control group.Among the MI patients,that of the allele E4 carrier was twice the frequency of the non-allele E4 carrier.③The relation was found between the risk factors of lipidemia and ApoE and MI by non-condition Logistic regression.TC>5.2 mmol/L,TG>2.26 mmol/L,LDL-C>3.4 mmol/L,TC/HDL-C>5.0 mmol/L were risk factors for MI;HDL-C>9.0 mmol/L was a protective factor for MI.Conclusion Dyslipidemia is an important risk factor for coronary heart disease and MI. The level of lipidemia were high among MI and the siblings,and the polymorphism of ApoE may be a risk factor of coronary heart disease and MI.