脑白质疏松症临床相关因素和脂质代谢障碍的研究

目的:探讨脑白质疏松症发病的相关因素和脂质代谢异常及载脂蛋白E基因多态性与脑白质疏松症的关系。方法:将脑白质疏松症、脑梗死和脑萎缩的277例病人进行CT与临床出院诊断的回顾性对比分析;采用聚合酶链反应———限制片段长度多态性技术对50例脑白质疏松症患者和108例正常对照者的载脂蛋白E基因型进行分析并进行血脂水平测定。结果:脑白质疏松症、脑梗死和脑萎缩三者的伴随疾病谱相似,但脑白质疏松症高血压、动脉粥样硬化和心脏病的伴随率分别为58.3%～75%,66.7%和41.7%～60%,均明显高于脑梗死和脑萎缩组(P<0.05)。脑白质疏松症、脑梗死和脑萎缩三者之间的伴发率极高。脑白质疏松症患者ApoE2等位基因频率为0.15,明显高于对照组的0.074(P<0.05);在脑白质疏松症患者中检测出携带有Apoε2/2纯合子基因者4例,高于对照组。携带ApoE2等位基因患者的甘油三酯,低密度脂蛋白;载脂蛋白B的含量均高于ApoE3等位基因患者。结论:脑白质疏松症、脑梗死与脑萎缩三者存在着共同相似的病因。载脂蛋白E2等位基因,尤其是ε2/2纯合子基因可能是脑白质疏松症的一种遗传易感因子。脑白质疏松症可能是通过以甘油三酯含量增高为主的高脂血症的途径而发病的。

THE STUDY ON THE CLINICAL FACTORS AND SERUM LIPID METABOLIC DISTURBANCE IN LEUKOARAIOSIS

Objective:To study the clinical factors and serum lipid metabolic disturbance in leukoaraeosis and the relationship between polymorphisms of apolipoprotein E gene and leukoaraeosis. Methods:CT images and clinical data have been retrospectively analyzed in 277 cases of leukoaraeosis, cerebral infarction and atrophy to detect accompanying problems. the genotype of Apo E was analyzed and the serum lipid level was tested in 50 LA patients in the study group as well as in 108 healthypersons in the control group by means of PCR,a restriction fragment length polymorphism )RFLP)technique. Result: the accompanying disorders were similar to leukoaraeosis, cerebral infarction and atrophyeach other in the 3 groups. However, hypertension, atherosclerosis and heart diseases showed an accompanying rate of 58.3 %～75 %,66.7 % and 41.7 %～60 % respectively with LA,much higher than that in both thecerebral infarction group and the atrophy group (P < 0.05). a high accompanying rate was detected in LA,cerebral infarction and atrophy. The frequency of Apo E2 allele in the LA group was 0.15, significantly higher than that (0.074) in the control group (P < 0.05(. The levels of TG, LDL-C and Apo B in LA patients with Apo E2 allele was significantly higher that in patients with Apo E3 allele. Conclusion: It is suggested that there was a common etiological factor in leukoaraeosis,cerebral infarction and atrophy each other in the 3 groups,Apo E2 allele might be a susceptible genetic factor for LA,and Apo E gene polymorphism couldresult in LA by affecting the serum lipidlevel of the patients.