血小板及形态学参数与APOE基因多态性致动脉粥样硬化性血管疾病的分析  

Influence of parameters of platelet and morphology and apolipoprotein E polymorphisms on arteriosclerotic cardiovascular disease

作　　者：夏迎龙 姚璐 田国祥[2] 刘杰[1] 李娜[3] 陈艳梅 武云涛 Xia Yinglong;Yao Lu;Tian Guoxiang;Liu Jie;Li Na;Chen Yanmei;Wu Yuntao(Department of Clinical Laboratory,Seventh Medical Center,Chinese PLA General Hospital,Beijing 100700,China;不详)

机构地区：[1]解放军总医院第七医学中心检验科,北京100700 [2]解放军总医院第七医学中心老年医学科,北京100700 [3]中国人民解放军96786部队卫生队,北京102202

出　　处：《中国循证心血管医学杂志》2025年第1期78-82,共5页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：吴阶平基金会课题(320.6750.18173)。

摘　　要：目的探讨血小板计数(PLT)及形态参数与载脂蛋白E(APOE)基因多态性对心脑血管疾病的影响。方法选择2022年8月至2023年10月于解放军总医院第七医学中心健康管理中心就诊的368例行冠状动脉CT或冠状动脉造影的患者为研究对象,给予全血细胞分析、血脂、凝血因子等化验检查;所有研究对象均给予APOE基因多态性分析,分析血小板计数及形态学参数与APOE基因多态性对心脑血管疾病的影响。结果APOE不同基因分型在冠状动脉粥样硬化性心脏病(冠心病)、脑卒中、外周动脉硬化、脂肪肝、高脂血症等因素中的分布差异具有统计学意义;E3,E4基因型在冠心病的发病率明显升高;E3基因型脑卒中的发病率明显升高(P<0.05)。E4基因型组的PLT、血小板压积、纤维蛋白降解产物、总胆固醇、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(ApoB)、糖化血红蛋白(HbAlc)、脂蛋白a[Lp(a)]、Gensini评分均高于其他两组(P<0.05);而空腹血糖、动脉硬化评分E3、E4组明显升高(P<0.05)。Logistic回归分析显示,冠心病与E4等位基因、PLT、血小板压积、动脉硬化评分正相关(OR值分别为10.726、2.553、3.637、1.496);脑卒中与E3等位基因、高血压、LDL-C、PLT、血小板平均体积正相关(OR值分别为3.245、4.966、2.794、2.273、1.731)。结论APOE基因多态性与心脑血管疾病的发生风险有关;APOE基因多态性导致心脑血管疾病的危险因素与PLT及形态学参数明确相关。Objective To investigate the influence of platelet count(PLT),platelet morphologic parameters and polymorphismsof apolipoprotein E(APOE)on arteriosclerotic cardiovascular disease(ASCVD).Methods The patients(n=368)undergone coronary computed tomography or coronary angiography(CAG)were chosen from Health Management Center of the Seventh Medical Center ofChinese PLA General Hospital from Aug.2022 to Oct.2023.All patients received laboratory examinations of whole blood cells,blood fat and coagulation factors.The analysis on APOEpolymorphisms was conducted in all patients,and influence of PLT,platelet morphologic parameters and APOEpolymorphisms on ASCVD were analyzed.Results The differences in different genotypes distribution had statistical significance in coronary heart disease(CHD),stroke,peripheralarteriosclerosis,fatty liver and hyperlipidemia.CHD incidence increased significantly in E3 genotype group and E4 genotype group,and stroke incidence increased significantly in E3 genotype group(P<0.05).The levels of PLT,plateletcrit(PCT),fibrin degradation product(FDP),total cholesterol(TC),low-density lipoprotein-cholesterol(LDL-C),apolipoprotein B(APOB),glycated hemoglobin(HbAlc),apolipoproteina[Lp(a)]and Gensini scores were higher in E4 genotype group than those in E2 genotype group and E3 genotype group(P<0.05),and levle of fasting plasma glucose(FPG)and arteriosclerosis scores increase significantly in E3 genotype group E4 genotype group(P<0.05).The results of Logistic regression analysis showed that CHD was correlated to E4allele(OR=10.726),PLT(OR=2.553),PCT(OR=3.637)and arteriosclerosis scores(OR=1.496).Stoke was positively correlated to E3allele(OR=3.245),hypertension(OR=4.966),LDL-C(OR=2.794),PLT(OR=2.273)and mean platelet volume(MPV,OR=1.731).Conclusion APOEpolymorphisms is related to risk of cardiovascular and cerebrovascular diseases.The risk factors of ASCVD related to APOEpolymorphisms are definitely correlated to PLT and platelet morphologic parameters.

关 键 词：冠状动脉粥样硬化性心脏病 动脉粥样硬化 载脂蛋白E 基因多态性 脑卒中 

分 类 号：R541.4[医药卫生—心血管疾病]