载脂蛋白E基因多态性及脂类代谢与缺血性脑卒中亚型关系的研究

目的探讨载脂蛋白E(apoE)基因多态性及脂类代谢与缺血性脑卒中亚型的关系。方法对急性动脉粥样硬化性脑梗死患者(ACI组)47例、腔隙性脑梗死患者(LI组)急性发作期48例、急性栓塞性脑梗死组患者14例和对照组50例,用聚合酶链反应限制性片段长度多态性进行apoE基因HhaI多态性测定,并进行血脂及载脂蛋白的测定。结果ACI组apoEε4等位基因频率明显高于其他脑卒中亚型及对照组(P<0.05)。ACI组的高密度脂蛋白胆固醇(HDL-C)水平明显低于其他3组,而低密度脂蛋白胆固醇(LDL-C)水平明显高于其他3组(P<0.05)。ACI组各等位基因间血脂水平比较,含ε4等位基因者LDL-C水平高于含ε3者(P<0.05)。无论是E3/3还是E3/4 ACI组的总胆固醇水平均高于对照组,HDL-C水平均低于对照组(P<0.05)。在E3/4 ACI组的LDL-C水平明显高于对照组。结论apoEε4等位基因与ACI发病及血脂代谢改变有关;LI的apoE基因多态性研究与ACI不一致,说明apoE基因多态性在LI的发病中无明显的致病作用;不同类型的脑卒中亚型急性发作期血脂水平不同。

Association of apolipoprotein E polymorphism with lipid metabolism and ischemic stroke subtypes

Objective To study the relationship between apolipoprotein E(apoE) polymorphism and lipid metabolism in patients with ischemic stroke subtypes.Method apoE phenotype was determined in 47 patients with acute atherosclerotic cerebral infarction(ACI),48 patients with acute lacunar infarction(LI),14 patients with acute embolic infarction(EI) and 50 normal controls by the polymerase chain reaction and restriction fragment length polymorphism technique.The lipids in serum of these subjects were measured.Results The differences of the apoE polymorphism distribution and apoE allele frequencies(P<0.05) occurred between the 4 groups.The frequency of apoE ε4 allele in patients with ACI was significantly higher than that in the normal controls(P<0.05).The TC in patients with ACI in the E3/3 and E3/4 groups was significantly higher than that in the normal controls(P<0.05).The LDL-C in patients with ACI in the E3/4 group was significantly higher than that in the normal controls(P<0.05).Conclusion apoE ε4 allele is associated with the development of ACI.Apolipoprotein E polymorphism affects lipid metabolism in ACI,but has no effect on LI mechanism.Different ischemic stroke subtypes have different lipid metabolism profiles.