冠心病合并阻塞性睡眠呼吸暂停患者载脂蛋白E水平及其基因型研究

目的 探讨冠心病(CAD)合并阻塞性睡眠呼吸暂停(OSA)患者载脂蛋白E(ApoE)等位基因频率及其水平的变化.方法 选择183例CAD患者,根据睡眠呼吸暂停低通气指数(AHI)分为OSA组(AHI≥5次/h)98例和CAD组(AHI<5次/h)85例;同时选择80例健康体检者作为对照组(AHI<5次/h).分别采用PCR-RELP和免疫比浊法测定ApoE基因型和ApoE水平.分析ApoE等位基因频率分布及其与ApoE水平相关性,比较3组患者ApoE水平和基因频率的差异,对睡眠呼吸参数与血脂指标进行相关性分析.结果 OSA组和CAD组患者的ε4等位基因频率分别为20.4%和21.2%,两组之间比较差异无统计学意义(P<0.05),但均明显高于对照组(6.3%);OSA组患者中ApoE水平(52.35±8.50)mg/L明显高于CAD组(46.21±7.21)mg/L和对照组(36.11±9.80)mg/L(均P<0.05);ApoE等位基因对应其ApoE水平为ε4<ε3<ε2,差异有统计学意义(P<0.05),但相同基因型其3组间ApoE水平比较差异无统计学意义(P>0.05);OSA组患者ApoE水平与AHI和低氧指数呈正相关.结论 CAD合并OSA患者ApoE水平与ApoE基因和OSA病情程度相关,但ApoE基因非OSA的易感因子.

Study on the correlation between apolipoprotein E and gene polymorphism in coronary artery disease patients with obstructive sleep apnea

Objective To investigate the correlation between polipoprotein E and gene polymorphism in coronary artery disease(CAD) patients with obstructive sleep apnea (OSA).Methods A total of 183 patients with proven CAD according to AHI were divided into OSA group (AHI≥5/h, n=98) and CAD group (AHI<5/h, n=85);and 80 healthy subjects were selected as control group (AHI<5/h).The level of ApoE and ApoE allel were measured and compared among the 3 groups.Results The ε4 frequencies in the OSA group and CAD group (20.4% vs.21.2%) were similar, but were both significantly higher than that in control group (6.3%, P<0.05).The level of ApoE was significantly higher in OSA group (52.35±8.50 mg/L) than in CAD group (46.21±7.21 mg/L) and control group (36.1±9.80 mg/L) (all P<0.05).The ApoE allele corresponding level of ApoE ε4 was significantly the highest and followed by ε3 and ε2 (P<0.05), but there was no significant difference in levels of ApoE among the three groups of the same genotype (P>0.05).The level of ApoE in OSA group was positively correlated with AHI and ODI.Conclusion The level of ApoE is correlated with OSA, but ApoE allele is not associated the susceptibility of OSA.