ApoE基因多态性与大动脉粥样硬化型脑梗死及卒中后认知障碍的相关性研究  

Correlation of ApoE gene polymorphisms with large artery atherosclerotic cerebral infarction and post-stroke cognitive impairment

作　　者：夏忠斌 桂敏 谈丹丹 柴竞艳 官燕琴 鲍兵 吴向斌 XIA Zhongbin;GUI Min;TAN Dandan;CHAI Jingyan;GUAN Yanqin;BAO Bing;WU Xiangbin(Department of Neurology,Affiliated Hospital of Jiujiang University,Jiujiang 332200,China)

机构地区：[1]九江学院附属医院神经内科,江西九江332200

出　　处：《广州医药》2025年第3期338-345,共8页Guangzhou Medical Journal

基　　金：江西省卫生健康委科技计划(20194033)。

摘　　要：目的探讨载脂蛋白E(ApoE)基因多态性与卒中后认知障碍的相关性,即大动脉粥样硬化型脑梗塞的严重程度。方法采用病例——对照研究的方法,收集九江学院附属医院神经内科的100例急性缺血性脑卒中且病因分型为大动脉粥样硬化型患者(脑梗死组)和50例性别、年龄匹配的非缺血性脑卒中患者(对照组)。检测患者的ApoE基因型、血脂、美国国立卫生院卒中量表(NIHSS)、卒中后6个月简易智力状态检查量表(MMSE)等,采用多因素方差分析等统计学方法分析他们之间的关联性。结果ApoE 3/4基因型频率与?3、?4等位基因频率,在脑梗死组别中高于对照组(P<0.05)。同时,携带?3等位基因患者的低密度脂蛋白水平高于携带?2、?4等位基因的患者;进一步分析发现含?3等位基因的脑梗死患者NIHSS评分更高、卒中后认知障碍更严重(P<0.05)。结论ApoE基因型为?3/4、等位基因?3、?4更易罹患大动脉粥样硬化型脑梗死,提示该基因型是脑梗死的易感基因,脑梗死后认知障碍患者?3等位基因的频率较高,可能是卒中后认知障碍的易感因素。Objective To explore the relationship between ApoE gene polymorphisms and post-stroke cognitive impairment,the severity of large artery atherosclerotic cerebral infarction.Methods A case-control research study was conducted,gathering data from 100 individuals diagnosed with large artery atherosclerotic cerebral infarction according to the TOAST classification,who admitted to the Neurology Department of the Affiliated Hospital of Jiujiang University.Additionally,50 non-ischemic stroke patients,matched for gender and age,were included as the control group.The patients were assessed for ApoE genotype,blood lipid,NIHSS,and MMSE scale at 6 months post-stroke,and statistical methods were used to analyze their associations.Results Significant differences were observed in the ApoE 3/4 genotype frequency andƐ3、Ɛ4 allele frequency between patients with cerebral infarction and the control group,with a notably higher incidence of cerebral infarction in the former.Furthermore,patients carrying theƐ3 allele exhibited significantly higher LDL levels than those carryingƐ2 orƐ4.The analysis also revealed that patients with theƐ4 allele experienced higher NIHSS and severer post-stroke cognitive impairment.Conclusions The findings suggest that the ApoE genotypeƐ3/4 and alleleƐ3、Ɛ4 may predispose individuals to develop large atherosclerotic cerebral infarction,indicating a susceptibility gene for cerebral infarction.Additionally,theƐ3 allele was associated with a higher frequency of cognitive deficits after cerebral infarction,implying that it may be a predisposing factor for post-stroke cognitive impairment.

关 键 词：APOE基因多态性 大动脉粥样硬化型 脑梗死 卒中后认知障碍 易感基因 等位基因 

分 类 号：R743.3[医药卫生—神经病学与精神病学]