载脂蛋白B基因多态性在高脂血症治疗中的意义

为观察小剂量伐他汀治疗高脂血症时载脂蛋白B基因变异对其疗效的影响，选择高脂血症病人61例，服用辛伐他汀（Simvastatin)5mg，每晚1次，治疗前及治疗后第4、8和12周分别抽血因脂指标及肝肾功能等，RFLPs方法检测ApoB基因XbaⅠ位点多态性。结果显示，61例高脂血症病人中检出X^＋X^－基因型5例，占8.20%；X^－X^－基因型56例，占91.80%，未检出X^＋X^＋基因型，X^＋等位基因频率为0.0410,X^-等位基因频率为0.9590治疗结果显示小剂量辛代他汀可有效降低血TC、TG、LDL－C和ApoB水平。在X^－X^－组中TC和DLD－C下降百分比较X^＋X^－组的大（P＜0.05）。提示高脂血症病人中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爱降脂治疗时疗效较差。

THE EFFECT OF APOLIPOPROTEIN B POLYMORPHISMS ON THE LIPID REGULATING THERAPY FOR HYPERLIPIDEMIA

To study the efficacy of small dosage of simvastatin on the treatment of hyperlipidemia, and the effect of polymorphisms in ApoB gene expression. Sixty one patients with hyperlipidemia were selected and simvastatin 5mg/d was used. TC, TG, HDL, LDL, ApoAI and ApoB and the function of liver and kidney were measured in every patient prior to the treatment and 4, 8, 12 weeks after treatment. RFLPs was applied for determination of polymorphisms on Xbal locus of the ApoB gene. In the total of 61 patients, X + X - genotype was found in 5 patients (8.20%), and X - X - genotype in 56 patients (91.80%), but no X + X + genotype was found. The relative frequency of X + allele was 0.041, and X - allele was 0.959, suggesting X - allele was still a dominant one in the patients with hyperlipidemia. The results showed that small dosage of simvastatin could effectively reduce blood levels of TC, TG, LDL C and ApoB. The levels of TC and LDL C lowering was more prominent in X - X - genotype than that in X + X - genotype (27.62% and 35.02% vs. 22.36% and 20.05%, P <0.05). There was no obvious difference in TG, HDL C ,ApoAI and ApoB in X + X - genotype compared with X - X - genotype. The relative frequency of X + allele was higher in patients with hyperlipidemia when compared to normal people. The effect of treatment with lipid lowering drug was weak with the patients who have this allele.