载脂蛋白B、E基因多态性对调脂疗效的影响

目的　观察小剂量辛伐他汀治疗高脂血症的疗效及载脂蛋白B、E基因变异对调脂药物疗效的影响。方法　选择高脂血症患者 88例 ,服用辛伐他汀 5mg,每晚 1次 ;于治疗前及治疗开始后第 4、8、12周抽血化验血脂指标。采用RFLPs方法检测ApoB基因XbaI位点多态性及ApoE基因多态性。结果　 88例高脂血症患者中X+ 等位基因相对频率为 0 .0 5 6 8,X- 等位基因相对频率为 0 .9432。ε2等位基因相对频率为 0 .1818,ε3等位基因相对频率为 0 .5 795 ,ε4等位基因相对频率为 0 .2 386。辛伐他汀可有效降低血胆固醇 (TC)、甘油三酯 (TG)、低密度脂蛋白 (LDL C)和ApoB水平。X+ X- 组的TC降低百分率较X- X- 组小 (13.6 4%比 2 3.88% ,P <0 .0 5 )。ε2 +基因型组TG、ApoB基础水平较ε3 3、ε3 4组高 (P <0 .0 5 ) ,治疗中ApoB下降百分率较ε3 3、ε3 4组大 (P <0 .0 5 )。结论　高脂血症患者中ApoB基因X+ 等位基因相对频率增高 ,携带此等位基因的人群其接受降脂治疗时疗效相对较差。高脂血症患者ApoE基因ε2、ε4等位基因相对频率增高 ,ε2等位基因与降脂治疗时ApoB变化大者相关

The effect of apolipoprotein B and E gene polymorphisms on the efficacy of lipid-regulating therapy

Objective To observe the efficacy of small dose of simvastatin in treatment of hyperlipidemia and to investigate the effect of polymorphisms in apoB and apoE gene on the efficacy of the treatment in hyperlipidemia.Methods Eighty-eight patients with hyperlipidemia were treated with simvastatin 5 mg/d.The TC,TG,LDL-C and ApoB were measured before treatment and 4,8,12 weeks of treatment.The polymorphisms of ApoB gene on XbaI locus and ApoE gene were determined by RFLPs method.Results In these 88 patients,the relative frequency of X + allele was 0.0568,and that of X - allele was 0.9432,whereas the relative frequency of ε2 allele was determined as 0.1818,ε3 allele as 0.5795,and ε4 allele as 0.2386.It was showed that simvastatin could effectively reduce blood level of TC,TG,LDL-C and apoB.The decrease in level of TC was more prominent in X -X - genotype than in X +X - genotype (23.88% vs 13.64%%).Compared with ε3,ε4 alleles,the ε2 allele caused higher percentage of reduction of ApoB.Conclusions The relative frequency of X + allele was significantly increased in patients with hyperlipidemia,and the efficacy of lipid-lowering therapy was decreased in patients with this allele.The relative frequencies of ε2 and ε4 alleles were also obviously increased in patients with hyperlipidemia,and the ε2 allele was associated with high reduction in apoB level during lipid lowering therapy.