载脂蛋白E基因多态性与初发急性缺血性脑卒中的相关性及其对近期预后的影响

 目的 探讨载脂蛋白E(apolipoprotein E, ApoE)基因多态性与初发急性缺血性脑卒中(acute ischemic stroke, AIS)的相关性,及其对AIS短期预后的预测价值。方法 选择2016-01至2018-01收治的445例初发AIS住院患者(初发AIS组)及363例体检者为研究对象(对照组)。全自动生化仪检测患者血脂、血糖等相关生化指标,采用实时荧光定量PCR的方法检测ApoE基因型。AIS患者按照中国急性缺血性脑卒中指南治疗。并于住院24 h内和出院6个月后,使用改良Rankin量表(modified Rankin scale, mRS)进行评估。采用χ²检验的方法,在不同人群分析ApoE基因多态性的差异。结果 在初发AIS患者中,ApoE基因型分布与对照组有统计学差异(χ² =13.31,P<0.01);入院即刻mRS>2组的患者中,ApoE 基因分型与mRS≤2组的患者明显不同(χ²=7.70,P<0.01)。出院后6个月,短期预后不良患者(mRS>2)ApoE基因型分布与预后较好的患者(mRS≤2)有统计学差异(χ²=11.31,P<0.01)。结论 ApoE基因多态性与初发AIS风险增加及严重性密切相关,并且该基因型可能是AIS短期预后不良的预测因素。

Correlations between apolipoprotein E gene polymorphism and initial acute ischemic stroke and its impact on short-term prognosis of AIS

Objective To investigate the relationships between Apolipoprotein E (ApoE) gene polymorphism and the initial acute ischemic stroke (AIS) while assessing its predictive value of short-term prognosis.Methods A total of 445 patients with AIS treated between January 2016 and January 2018 were selected and another 363 medical examinees were enrolled as controls in the study. Blood lipids, blood glucose and other related biochemical indicators were tested by the automatic biochemical analyzer. The ApoE genotype was detected by real-time fluorescent quantitative PCR. The enrolled AIS patients were treated according to China’s guidelines for acute ischemic stroke, and were evaluated using mRS (Modified Rankin Scale) within 24 hours of hospitalization and 6 months after discharge. Chi-square test was used to analyze the correlations between ApoE genotype and AIS prognosis.Results The ApoE genotype distribution of the 445 initial AIS patients was significantly different from that of the normal control group (χ²=13.31, P<0.01). For patients with immediate mRS>2 admission, ApoE genotyping was significantly different from that of the mRS ≤2 patients (χ²=7.70, P<0.01). Six months after discharge, patients with poor short-term prognosis (mRS>2) had different ApoE genotypes from patients with good prognosis (mRS≤2,χ²=11.31, P<0.01).Conclusions The ApoE gene polymorphism is closely related to the occurrence of initial AIS, which may be a predictor of poor short-term prognosis of AIS.