载脂蛋白E基因对轻、中型创伤性脑损伤急性期脑电活动的影响  

Influence of apolipoprotein E polymorphism on acute-phase brain electrical activity after mild/ moderate traumatic brain injury

作　　者：印晓鸿[1] 孙晓川[1] 张晓冬[1] 但炜[1] 刘科[2] 吴海涛[1] 刘福英[1] 贺绪智[1] 林斌[1] 

机构地区：[1]重庆医科大学附属第一医院神经外科,400016 [2]重庆市急救医疗中心神经外科

出　　处：《中华创伤杂志》2010年第11期1006-1010,共5页Chinese Journal of Trauma

基　　金：重庆市科委自然科学基金资助项目（2007BB5299）;重庆市卫生局医学科技计划重点资助项目（05-1-017）

摘　　要：目的 探讨载脂蛋白E基因（APOE）对轻、中型创伤性脑损伤后急性期脑电活动的影响.方法 收集112例轻、中型创伤性脑损伤患者的临床资料,采用聚合酶链反应限制性片段长度多态性法（PCR-RFLP）检测APOE基因型;在伤后1周内对全部患者进行两次脑电图检测,采用定性及定量的方法判断脑电活动的变化;对APOE分型结果、脑电图及临床资料等应用SPSS 11.5统计学软件分别进行x2检验、方差分析和Logistic回归分析.结果 112例患者的APOE分型分布符合遗传学Hardy-Weinberg定律;在22例APOEε4携带者中有12例（55%）脑电图加重,其比率明显高于非ε4携带者（18%,P＜0.01）;通过定量指标的分析发现,经过4～5 d的正规治疗,携带APOEε4的患者脑电图慢波增多（P＜0.01）,而携带APOEε2、APOEε3的患者脑电图慢波减少（P＜0.05）,APOEε2携带者前后两次脑电图慢波减少的程度较APOEε3携带者更明显（P＜0.05）.单因素和多因素Logistic回归分析均提示,APOEε4是脑电图加重的危险因素.结论 APOEε4等位基因是轻、中型脑损伤患者急性期脑电图加重的危险因素,而APOEε2有利于脑电活动的恢复.Objective To investigate the influence of apolipoprotein E gene （APOE） polymorphism on the acute-phase brain electrical activity after mild/moderate traumatic brain injury. Methods The clinical data of 112 patients with mild/moderate traumatic brain injury were collected and the APOE genotypes were identified by polymerase chain reaction-restriction fragment length polymorphism （PCR-RFLP）. The brain electrical activity in every patient was recorded twice by using electroencephalogram within one week after injury. Qualitative and quantitative methods were used to determine the variations of brain electrical activity. Chi-square test, variance analysis and logistic regression analyses via SPSS version 11.5 were performed among APOE genotypes, electroencephalogram data and clinical data. Results The distributions of APOE genetypes and alleles matched Haldy-Weinberg Law in 112 patients. Of 22 patients with APOEε4, 12 patients （55%） presented with deteriorated electroencephalogram, which was significantly higher than those （16 of 90 patients, 18%） without APOEε4 （P 〈 0. 01）. Comparison of the first and second electroencephalograms demonstrated that the slow waves were increased significantly in patients with APOEε4 （ P 〈 0. 01 ） but decreased in patients with APOEε2 and APOEε3 （P 〈0.05）. The reduction of slow waves in APOEε2 carriers was more obvious than APOEε3 carriers （P 〈0.05）. Univariate and multivariate logistic regression analyses showed that APOEε4 was a risk factor to electroencephalogram aggravation after traumatic brain injury. Conclusion APOEε4 is a risk factor to electroencephalogram aggravation during acute stage after mild/moderate traumatic brain injury. However,APOEε2 seems to be beneficial for recovery of brain electrical activity.

关 键 词：腑损伤 载脂蛋白E类 脑电图 

分 类 号：R686[医药卫生—骨科学]