载脂蛋白E基因多态性与颅脑损伤后认知功能障碍的相关性研究  

Relationship between apolipoprotein E gene polymorphism and cognitive dysfunction after traumatic brain injuries

作　　者：熊海兵[1] 郭鑫 霍建宏 何友虎 梅华锋 曾实 Xiong Haibing;Guo Xin;Huo Jianhong;He Youhu;Mei Huafeng;Zeng Shi(Department of Neurosurgery,Banan Hospital Affiliated to Chongqing Medical University,Chongqing 401320,China)

机构地区：[1]重庆医科大学附属巴南医院神经外科,重庆401320

出　　处：《创伤外科杂志》2024年第9期682-685,共4页Journal of Traumatic Surgery

基　　金：重庆市科卫联合医学科研项目(2021MSXM261)。

摘　　要：目的探讨载脂蛋白E(ApoE)基因多态性与颅脑损伤后认知功能障碍的关系。方法前瞻性选取2018年1月—2023年2月重庆医科大学附属巴南医院神经外科收治的57例颅脑损伤后认知功能患者为认知功能障碍组,同期收治的不伴有认知功能障碍的颅脑损伤患者51例为对照组。取患者抗凝静脉全血2~4 mL进行核酸提取,使用APOE基因检测试剂盒,采用多重荧光PCR法对提取的DNA进行APOE基因ε2、ε3和ε4位点的检测,比较两组基因型分布差异。用Logistic回归分析对两组患者一般资料及携带ε2、ε3和ε4基因进行筛选,得出颅脑损伤后认知功能障碍的基因危险因素。结果两组患者基因型分布差异有统计学意义(P<0.05),两组ε3基因携带者和ε4基因携带者占比有明显差异(P<0.05)。单因素Logistic回归分析提示,仅携带ε4为颅脑损伤后认知功能障的危险因素[P=0.005,OR=0.317(95%CI:0.142~0.711)]。把单因素Logistic回归中P值最低的5个变量(GCS、性别、损伤程度及ε3、ε4携带者)所有因素纳入多因素Logistic回归分析,发现携带ε4基因是颅脑损伤后认知功能障的危险因素[P=0.039,OR=0.379(95%CI:0.150~0.954)]。结论ApoEε4基因与颅脑损伤后认知功能障碍有关。Objective:To explore the relationship between apolipoprotein E(APOE)gene polymorphism and cognitive dysfunction(CD)after traumatic brain injuries(TBI).Methods Fifty-seven TBI patients with CD treated in the Department of Neurosurgery of Banan Hospital Affiliated to Chongqing Medical University from Jan.2018 to Feb.2023 were selected as the CD group;another 51 TBI patients admitted at the same time without CD were selected as the control group.The data of gender,age,GCS,injury severity,and combination of brain contusion/subarachnoid hemorrhage/subdural hematoma were recorded.Anticoagulant venous blood of 2-4 mL was sampled for all patients,and the DNA was extracted by multiple fluorescence PCR.An APOE gene detection kit was used to test the APOE alleles(ε2,ε3 andε4).Genotypic differences and the abovementioned parameters were compared between the two groups.Logistic regression analysis was used to screen risk factors of CD after TBI.Results Gender,age,GCS,injury severity,and combination of brain contusion/subarachnoid hemorrhage/subdural hematoma showed no significant differences between the two groups,except for the APOE alleles(P<0.05),which revealed a significantly lower percent ofε3 gene carriers and a significantly higher percent ofε4 gene carriers in the CD group(both P<0.05).Univariate logistic regression analysis of all the parameters showed that only theε4 carrier was a risk factor for CD after TBI(P=0.005,OR=0.317,95%CI=0.142-0.711);multifactorial logistic regression analysis of GCS,gender,injury severity,ε3 carrier andε4 carrier showed the same result of the singer risk factor ofε4 carrier(P=0.039,OR=0.379,95%CI=0.150-0.954).Conclusion APOEε4 gene is associated with CD after TBI.

关 键 词：颅脑损伤 载脂蛋白E APOE基因 认知功能障碍 

分 类 号：R651.1[医药卫生—外科学]