ApoE基因多态性对缺血性脑梗死患者他汀类降脂药物治疗效果的影响

目的:分析载脂蛋白E( ApoE)基因多态性对缺血性脑梗死患者他汀类降脂药物疗效的影响。 方法:选取缺血性脑梗死患者106例，连续给予他汀类降脂药物3个月，分析服药前后血清三酰甘油(triglyceride，TG)、胆固醇(total cholesterol，TC)、高密度脂蛋白固醇(high-d...

Influence of ApoE gene polymorphisms on therapeutic effects of lipid-lowering statins among patients with ischemic cerebral infarction

Objective To assess the influence of apolipoprotein E(ApoE)gene polymorphisms on the therapeutic effect of lipid-lowering statins in patients with ischemic cerebral infarction.Methods One hundred and six patients with ischemic cerebral infarction who orally took lipid-lowering statins for 3 months were enrolled.Changes in serum triacylglycerol(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C)before and after the drug administration were analyzed.ApoE gene polymorphisms were detected by real-time fluorescent quantitative PCR,and genotypes of ApoE gene in patients with different effects were compared.Results The detection rates for E2/E2,E2/E3,E3/E3,E2/E4 and E3/E4 genotypes were 0.94%,11.32%,63.21%,1.89%and 22.64%,respectively.And the detection rates for E2,E3 and E4 alleles were 7.55%,80.19%and 12.26%,respectively.Biochemical phenotypes included E2 type(13 cases,12.26%),E3 type(69 cases,65.09%)and E4 type(24 cases,22.65%).Before administration,TG and TC of E2 type were the highest(P<0.05),but no significant difference was detected in HDL-C and LDL-C among the three phenotypes(P>0.05).Following the drug administration,TG,TC and LDL-C were decreased,while HDL-C was increased.HDL-C of E2 type was the highest,TC and LDL-C of E4 type were the highest(P<0.05).The E3/E3 ratio in low-efficiency group at admission was lower than that in the high-efficiency group,while the E3/E4 ratio was higher than that in the high-efficiency group(P<0.05).The proportion of E3 allele in low-efficiency group was lower than that in high-efficiency group,while the proportion of E4 allele was higher than that in high-efficiency group(P<0.05).Conclusion ApoE gene polymorphisms are closely correlated with the therapeutic effect of lipid-lowering statins in patients with ischemic cerebral infarction.The lipid-lowering effects are more significant in patients with E2 and E3 genotypes,but were poor in those with the E4 genotype.Personalized regimens should be applied.