缺血性脑卒中患者ApoE基因多态性和IL⁃6、IL⁃10、TNF⁃α与衰弱综合征的关系  

Relationship between ApoE gene polymorphism,IL⁃6,IL⁃10,TNF⁃αand asthenic syndrome in patients with ischemic stroke

作　　者：刘佳 朱喜悦 周丽英 LIU Jia;ZHU Xiyue;ZHOU Liying(Department of Geriatrics,Shanghai Fengxian Central Hospital,Shanghai,China,201400)

机构地区：[1]上海市奉贤区中心医院老年医学科,上海201400

出　　处：《分子诊断与治疗杂志》2024年第12期2338-2341,2346,共5页Journal of Molecular Diagnostics and Therapy

基　　金：上海浦东新区卫生健康委员会面上项目(PW2021⁃46)。

摘　　要：目的探讨缺血性脑卒中(IS)患者载脂蛋白E(ApoE)基因多态性、白介素(IL)⁃6、IL⁃10、肿瘤坏死因子⁃α(TNF⁃α)与衰弱综合征的关系。方法选取2021年1月至2023年12月上海交通大学附属第六人民医院南院治疗120例IS患者。根据治疗后衰弱综合征发生情况分为衰弱综合征组(n=44)和无衰弱综合征组(n=76)。单因素、Logistic回归分析ApoE基因多态性、血清IL⁃6、IL⁃10、TNF⁃α水平与IS患者衰弱综合征的关系,受试者工作曲线(ROC)分析血清指标水平对IS衰弱综合征的预测价值。结果两组营养不良、纯合子基因e3/3、e4/4、等位基因e3、e4及血清IL⁃6、IL⁃10、TNF⁃α水平比较,差异有统计学意义(P<0.05)。营养不良、ApoE e4、e4/4、血清IL⁃6、IL⁃10、TNF⁃α水平升高是IS患者衰弱综合征的危险因素(均P<0.05);ApoE e3、e3/3基因是IS患者衰弱综合征的保护因素(P<0.05)。血清IL⁃6、IL⁃10、TNF⁃α水平检测及联合检测预测IS衰弱综合征的曲线下面积(AUC)值分别为0.831、0.883、0.821、0.956(均P<0.05)。结论ApoE基因多态性和IL⁃6、IL⁃10、TNF⁃α与IS患者衰弱综合征相关,携带e4基因增加衰弱综合征风险,携带e3基因抑制衰弱综合征风险,血清指标联合检测对患者衰弱综合征有较高的预测价值。Objective To investigate the relationship between apolipoprotein E(ApoE)gene polymorphism,interleukin⁃6,IL⁃10,tumor necrosis factor⁃α(TNF⁃α)and asthenic syndrome in patients with ischemic stroke(IS).Methods 120 patients with IS were selected from the South Hospital of the Sixth People's Hospital Affiliated with Shanghai Jiao Tong University from January 2021 to December 2023.Based on the incidence of asthenic syndrome after treatment,they were divided into an asthenic syndrome group(n=44)and a non⁃asthenic syndrome group(n=76).The relationship between ApoE gene polymorphism,serum IL⁃6,IL⁃10,and TNF⁃αlevels and the asthenic syndrome of IS patients was analyzed using univariate logistic regression.The receiver operating curve(ROC)was used to analyze the predictive value of serum level in IS asthenic syndrome.Results There were significant differences in the levels of malnutrition,homozygous genes E3/3,E4/4,alleles e3,e4 and serum IL⁃6,IL⁃10,and TNF⁃αbetween the two groups(P<0.05,re⁃spectively).Malnutrition,ApoE e4,E4/4 gene carriers,and elevated serum levels of IL⁃6,IL⁃10,and TNF⁃αare risk factors for debilitating syndrome in IS patients(P<0.05).ApoE e3,e3/3 gene carrier was a protec⁃tive factor for debilitating syndrome in IS patients(P<0.05).The area under the curve(AUC)values of serum IL⁃6,IL⁃10,and TNF⁃αlevels and combined detection for predicting IS asthenic syndrome were 0.831,0.883,0.821 and 0.956,respectively(P<0.05).Conclusion The ApoE gene polymorphism,along with IL⁃6,IL⁃10,and TNF⁃αis associated with the asthenic syndrome in IS patients.Carrying the e4 gene increases the risk of asthenic syndrome,while carrying the e3 gene suppresses this risk.The combined detection of serum indicators has a high predictive value for patients with asthenic syndrome.

关 键 词：缺血性脑卒中 衰弱综合征 APOE基因多态性 

分 类 号：R743.3[医药卫生—神经病学与精神病学]