载脂蛋白E基因多态性对血脂及冠心病、颈动脉粥样硬化的影响  

Effect of apolipoprotein E polymorphism on serum lipids, coronary heart disease, and carotid artery atherosclerosis

作　　者：张原力[1,2] 游凯[1,2] 张丽华[1,2] 姜玉新 薛红[1,2] 陈保生 方圻 

机构地区：[1]中国医学科学院协和医科大学北京协和医院内科 [2]基础医学研究所生化国家重点实验室

出　　处：《中华心血管病杂志》1998年第6期443-447,共5页Chinese Journal of Cardiology

摘　　要：目的探讨ＡｐｏＥ基因多态性对中国人血脂水平的影响及与冠心病发病、颈动脉粥样硬化程度的关系。方法选择９６例冠心病患者（ＣＨＤ组）及１３１例健康对照者（对照组），测定空腹血清甘油三脂（ＴＧ）、总胆固醇（ＴＣ）、高密度脂蛋白胆固醇（ＨＤＬＣ）及低密度脂蛋白胆固醇（ＬＤＬＣ）浓度。应用ＰＣＲ，ＨｈａＩ内切酶消化及ＰＡＧＥ的方法确定ＡｐｏＥ基因多态性。采用高分辨二维超声技术测定双侧颈动脉内中膜厚度。结果ＣＨＤ组与对照组相比，ＡｐｏＥ基因型频率及ε２，ε３，ε４三种等位基因频率均无显著差异（Ｐ＞０．０５）；在男性ＣＨＤ患者及健康对照者，不同的ＡｐｏＥ基因型ＴＣ，ＬＤＬＣ浓度差异均有显著性，并按ε２／２＋ε２／３＜ε３／３＜ε３／４＋ε４／４的顺序递增。在女性虽有相似的趋势，但未达统计学显著水平；５２例男性ＣＨＤ患者测定了颈动脉内中膜厚度，并按不同的ＡｐｏＥ基因型分成三组：ε２／２＋ε２／３，ε３／３，ε３／４＋ε４／４，结果显示：颈动脉内中膜厚度及多发粥样硬化斑块发生率在不同的ＡｐｏＥ基因型间差异有显著性（Ｐ＜０．０１），含ε４等位基因者显著增加，当消除ＬＤＬＣ的影响后上述差异仍显著（Ｐ＜０．０５）。结论Ａｐ?Objective To elucidate the effect of apolipoprotein E polymorphism on serum lipids and the relationship between apolipoprotein E polymorphism and coronary heart disease (CHD) as well as carotid artery atherosclerosis in Chinese people.Methods Serum triglyceride, total cholesterol (TC), low density lipoprotein cholesterol (LDL C) and high density lipoprotein cholesterol (HDL C) were measured. Polymerase chain reaction (PCR), HhaI digestion, polyacrylamide gel electrophooresis, and silver staining were used for the detection of apolipoprotein E genotype. In 52 male CHD cases, an extracranial carotid artery high resolution B mode ultrasound examination was performed. Results There were no statistically significant differences in apoplipoprotein E allel or genotype frequences between CHD cases and controls ( P >0.05). In male CHD cases and controls, the genotypes were associated with serum TC and LDL C levels in the following order: ε2/2+ε2/3<ε3/3<ε3/4+ε4/4(P<0.01). In women, there were a similar trend but not statistically significant ( P >0.05). The carotid artery intima media thickness and frequence of multiatherosclerotic plaques were significantly higher in male CHD cases with ε4 allel ( P <0.01 and 0.04), and still did not change the effect of ε4 on intima media thickness after adjusting for LDL C levels.Conclusions Apolipoprotein E gene polymorphism affects serum TC and LDL C levels in Chinese people. Apolipoprotein E genotypes affect severity of carotid artery atherosclerotic lesions, but the effect may not be mediated entirely by changes of serum cholesterol. ε4 allel is a risk factor.

关 键 词：冠心病 颈动脉粥样硬化 载脂蛋白E 基因多态性 

分 类 号：R541.4[医药卫生—心血管疾病]