脑白质疏松症临床相关因素和脂质代谢障碍的研究  

The Study on the Clinical Factors and Serum Lipid Metabolic Disturbance in Leukoaraiosis

作　　者：陈志斌[1] 涂蓉[1] 钱士匀[1] 蔡美华[1] 姚红霞[1] 苏庆杰[1] 王埮[1] 欧小凡[1] 陈蓉[1] 吴志明[1] 

机构地区：[1]海南医学院附院神经内科,海口570102

出　　处：《医学研究通讯》2005年第3期13-16,共4页Bulletin of Medical Research

摘　　要：目的探讨脑白质疏松症发病的相关因素和脂质代谢异常及载脂蛋白 E 基因多态性与脑白质疏松症的关系。方法将脑白质疏松症、脑梗死和脑萎缩的277例病人进行 CT 与临床出院诊断的回顾性对比分析;采用聚合酶链反应一限制片段长度多态性技术对50例脑白质疏松症患者和108例正常对照者载脂蛋白 E 基因型进行分析并进行血脂水平测定。结果脑白质疏松症、脑梗死和脑萎缩三者的伴随疾病谱相似,但脑白质疏松症高血压、动脉粥样硬化和心脏病的伴随率分别为58.3～75%,66.7%和41.7～60%均明显高于脑梗死和脑萎缩组(P<0.05)。脑白质疏松症、脑梗死和脑萎缩三者之间的伴发率极高。脑白质疏松症患者 ApoE2等位基因频率为0.15,明显高于对照组的0.074(P<0.05);在脑白质疏松症患者中检测出携带有 Apoε2/2纯合子基因者4例,高于对照组。携带 ApoE2等位基因患者的甘油三酯,低密度脂蛋白;载脂蛋白 B 的含量均高于ApoE3等位基因患者。结论脑白质疏松症、脑梗死与脑萎缩三者存在着共同相似的病因。载脂蛋白 E2等位基因,尤其是ε2/2纯合子基因可能是脑白质疏松症的一种遗传易感因子。脑白质疏松症可能是通过以甘油三酯含量增高为主的高脂血症的途径而发病的。Objective To study the clinical factors and serum lipid metabolic disturbance in leukoaraiesis and the relationship between poly- morphisms of apolipoprotein E gene and leukoaraiosis.Methods CT images and clinical data have been retrospectively analyzed in 277 cases of leukoaraeesis,cerebral infarction and atrophy to detect accompanying problems,the genotype of ApoE was analyzed and the serum lipid level was assayed in 50 LA patients in the study group as well as in 108 healthy persons in the control group by means of PCR,a restriction fragment length polymorphism(RFLP)technique.Results The accompanying disorders Spectrum was similar in leukoaraiosis,cerebral infarction and atrophy. However,hypertension,atherosclerosis and heart diseases showed an accompanying rate of 58.3～75%,66.7% and 41.7～60% respectively with LA,much higher than that in both the cerebral infarction group and the atrophy group(P<0.05).A high accompanying rate was detected in LA,cerebral infarction and atrophy.The frequency of ApoE2 allele in the LA group was 0.15,significantly higher than that(0.074)in the control group(P<0.05).The levels of TG,LDL-C and ApoB in LA patients with ApoE2 allele was significantly higher than that in patients with ApoE3 allele.Conclusion It is suggested that there was a common etiological factor in leukoaraiosis,cerebral infarction and atrophy group, ApoE2 allele might be a susceptible genetic factor for LA,and ApoE gene palymorphism could result in LA by affecting the serum lipid level of the patients.

关 键 词：脑白质疏松症 脑萎缩 患者 脑梗死 脂质代谢障碍 对照组 临床相关因素 等位基因频率 纯合子 载脂蛋白E 

分 类 号：R742[医药卫生—神经病学与精神病学] R743.33[医药卫生—临床医学]