阿托伐他汀对不同ApoE基因型冠心病患者血脂调控影响的临床研究  

Clinical study on influence of atorvastatin on blood lipid regulation in coronary heart disease patients with different ApoE genotypes

作　　者：郑文武[1] 李正业 李翔[3] 黄立[2] 蒋灿[1] 刘盼[1] 黄冬梅[1] 刘茜[1] 

机构地区：[1]泸州医学院附属医院心内科,四川泸州646000 [2]四川省泸州市叙永县人民医院心内科,646400 [3]四川省泸州市人民医院心内科,646000

出　　处：《检验医学与临床》2015年第18期2671-2673,共3页Laboratory Medicine and Clinic

基　　金：四川省卫生和计划生育委员会基金资助项目(12195);泸州医学院附属医院基金课题(11238)

摘　　要：目的运用限制性片段长度多态性聚合酶链反应（PCR-RFLP）技术,检测冠心病患者ApoE基因型以及阿托伐他汀对不同ApoE基因患者血脂调控的影响,探讨冠心病的发病机制及阿托伐他汀对其预后的影响。方法选取2013年1-12月泸州医学院附属医院心内科收治的冠心病住院患者116例作为冠心病组,另取同期健康体检者50例作为健康对照组,通过PCR-RFLP技术测定ApoE基因型,测定冠心病组服用阿托伐他汀治疗前及治疗12周后的血脂水平,分析基因型与调脂疗效的关系。结果冠心病患者中,ApoE E3/4、E4/4基因型和ε4等位基因频率显著高于健康对照组,差异有统计学意义（P〈0.05）;ε4等位基因组,血脂TC和LDL-C水平显著高于其他等位基因组,差异有统计学意义（P〈0.05）;阿托伐他汀治疗12周后,ApoE E2/2＋E3/2、E3/3与E4/3＋E4/4等位基因组比较,治疗后患者血浆中的TC、LDL-C和HDL-C水平差异有统计学意义（P〈0.05）。结论 ApoE基因型E3/4、E4/4及ε4等位基因有可能参与了冠心病的发生、发展过程,阿托伐他汀对ApoE E2/2＋E3/2、E3/3等位基因组冠心病患者降脂效果更好,而对E4/3＋E4/4等位基因组冠心病患者效果不确切。Objective To observe ApoE genotypes in the patients with coronary heart disease（CHD） by using the PCR‐RFLP technique ,to observe the impact of atorvastatin on blood lipid regulation in the patients with different ApoE genes ,and to investigate the pathogenesis of CHD and the influence of atorvastatin on prognosis .Methods 116 patients with CHD in the cardiology department of the Affiliated Hospital of Luzhou Medical College from January to December 2013 were selected as the CHD group ,and contemporaneous 50 individuals undergoing physical examination were selected as the healthy control group .The ApoE genotypes were detexcted by using the PCR‐RFLP technique .The blood lipid level before atorvastatin treatment and after 12‐week treatment was detected .The relation between the genotypes and the lipid regulation effect was analyzed .Results The frequency of ApoE E3/4 ,E4/4 genotypes and ε4 allele in the CHD group were significantly higher than those in the control group ,the differences were statistically significant （P〈 0 .05） ;the TC and LDL‐C levels in the ApoE ε4 allele group were significantly higher than those in the other allele groups ,the differences were statistically significant （P 〈 0 .05） .Compared the ApoE E2/2 ＋ E3/2 ,E3/3 allele group with the E4/3 ＋ E4/4 allele group after 12‐week atorvastatin treatment ,the plasma levels of TC ,LDL‐C and HDL‐C had statistical differences （P 〈 0 .05） .Conclusion ApoE genotype E3/4 ,E4/4 as well as ε4 allele might participate in the occurrence and development process of CHD .Atorvastatin has better lipidlowering effect in the patients with ApoE E2/2 ＋ E3/2 ,E3/3 allele ,while has inexact effect in the patients with E4/3＋ E4/4 allele .

关 键 词：冠心病 APOE基因 基因多态性 阿托伐他汀 血脂 

分 类 号：R749.16[医药卫生—神经病学与精神病学]