载脂蛋白Eε4等位基因对阿尔茨海默病患者认知功能和P300的影响

The effects of apolipoprotein E epsilon 4 on cognitive function and P300 latency of Alzheimer's disease

目的:研究载脂蛋白E(ApoE)ε4等位基因对阿尔茨海默病(Alzheimer'sdisease,AD)患者总体认知功能和P300的影响。方法:选取做过P300检查和ApoE基因分析的所有轻中度AD患者20例作为研究对象,根据是否携带ApoEε4等位基因分为携带组8例,非携带组12例。对两组间简明精神状态检查(MMSE)成绩和P300潜伏期(P300peaklatency,P3PL)的差异进行分析,并进一步分析了年龄、MMSE成绩和P3PL之间的相关性。结果:ApoEε4等位基因携带组平均年龄高于非携带组犤(81±4)比(77±4)岁,t=2.19,P=0.0419犦,MMSE成绩低于非携带组犤(19.5±2.2)比(21.6±1.8)分,t=2.34,P=0.0309犦,P3PL表现出延长的趋势犤(386±21)比(360±30)ms,t=2.12,P=0.0481犦。但年龄与MMSE之间(r=-0.4013,P=0.0795)以及年龄和P3PL之间(r=0.3861,P=0.0927)均无相关性,MMSE对P3PL也无显著性影响(r=-0.0484,P=0.8396)。结论:AD患者中,ApoEε4等位基因携带者认知功能衰退更明显,并且其P3PL也明显延长,说明不同的ApoEε4表现型可能具有不同的认知和P300表现模式。

AIM: To investigate the effects of apolipoprotein E epsilon4 (ApoEε4)on cognitive function and P300 of Alzheimer's disease(AD). METHODS: Twenty AD patients who had taken both the P300 examination and ApoE genotype detection were enrolled in this study and were classified asε4 group (n=8)and non ε4 group (n=12). Scores of mini Mental State Examination (MMSE) and P300 latency between the two groups were analyzed. The relationship of the age to the scores of MMSE and P3PL were studied and analyzed further. RESULTS: The mean age of the patients withε4 carriers was (81±4) years, significantly older than (77±4) years of the patients withoutε4 carriers (t=2.19, P=0.041 9). The scores of MMSE in theε4 group were 19.5±2.2, significantly lower than 21.6±1.8 in the non ε4 group (t=2.34,P=0.030 9).The P300 latency of theε4 group was (386±21) ms, significantly shorter than (360±30) ms of the non ε4 group (t=2.12,P=0.048 1). There was no correlation between the age and the scores of MMSE (r =-0.401 3,P=0.079 5), between the age and P3PL (r =0.3861,P =0.092 7)and between the scores of MMSE and P3PL(r =-0.048 4,P=0.839 6). CONCLUSION: In patients with AD the cognitive function declines markedly and the P3PL prolonges markedly. It indicates that varied ApoEε4 phenotype may have different phenotypic expressions of cognitive function and P300.