CAJ | 학술논문

目的了解载脂蛋白E(APOE)基因多态性与高血压脑出血(HICH)发病的关系. 方法设计对照研究,对川北医学院附属医院神经外科自2007年9月至2010年12月收治的128例HICH患者(HICH组)及84例正常成人(对照组)采用聚合酶链反应限制性片段长度多态性法(PCR-RFLP)检测APOE基因型,比较2组对象APOE基因型及等位基因频率的差异,并进一步比较不同A POE基因型患者发病年龄、性别、血压、血脂、出血部位、血肿大小等因素的差异. 结果 HICH组有吸烟嗜好、糖尿病史的比例以及总胆固醇(TC)、低密度脂蛋白(LDL-C)浓度均明显高于对照组,差异有统计学意义(P＜0.05).HICH组APOEε3/4基因型及APOEε4等位基因的分布频率明显高于对照组,而APOEε3/3基因型、APOEε3等位基因的分布频率明显低于对照组,差异有统计学意义(P＜0.05).HICH组中APOEε3/4基因型及APOEε4等位基因携带者的发病年龄≤45岁和浅部出血的比例以及LDL-C及TC血浆浓度均明显高于APOEε3/3基因型及APOEε3等位基因携带者,发病时收缩压明显低于APOEε3/3基因型及APOEε3等位基因携带者,差异均有统计学意义(P＜0.05). 结论 APOE基因多态性对HICH的发生有重要影响,影响因素包括发病年龄、血压、血脂以及出血的部位,其机制可能与影响动脉粥样硬化和血管淀粉样变有关.
목적 료해재지단백E(APOE)기인다태성여고혈압뇌출혈(HICH)발병적관계. 방 법 설계대조연구,대천북의학원부속의원신경외과자2007년9월지2010년12월수치적128례HICH환자(HICH조)급84례정상성인(대조조)채용취합매련반응한제성편단장도다태성법(PCR-RFLP)검측APOE기인형,비교2조대상APOE기인형급등위기인빈솔적차이,병진일보비교불동A POE기인형환자발병년령、성별、혈압、혈지、출혈부위、혈종대소등인소적차이. 결과 HICH조유흡연기호、당뇨병사적비례이급총담고순(TC)、저밀도지단백(LDL-C)농도균명현고우대조조,차이유통계학의의(P＜0.05).HICH조APOEε3/4기인형급APOEε4등위기인적분포빈솔명현고우대조조,이APOEε3/3기인형、APOEε3등위기인적분포빈솔명현저우대조조,차이유통계학의의(P＜0.05).HICH조중APOEε3/4기인형급APOEε4등위기인휴대자적발병년령≤45세화천부출혈적비례이급LDL-C급TC혈장농도균명현고우APOEε3/3기인형급APOEε3등위기인휴대자,발병시수축압명현저우APOEε3/3기인형급APOEε3등위기인휴대자,차이균유통계학의의(P＜0.05). 결론 APOE기인다태성대HICH적발생유중요영향,영향인소포괄발병년령、혈압、혈지이급출혈적부위,기궤제가능여영향동맥죽양경화화혈관정분양변유관.
Objective To investigate the relationship between apolipoprotein E (APOE) genotype and onset of hypertensive intracerebral hemorrhage (HICH). Methods One hundred and twenty-eight patients with HICH,admitted to our hospital from September 2007 to December 2010,and 84 healthy controls clinically flee from neurology disease were chosen in our study.A POE genotype was determined using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP); the distribution ofAPOE genotype and allele fiequency between the 2 groups were compared; the age of onset,gender,blood pressure,blood fat,bleeding part and size of haematoma in patients with different APOE genotype were further studied. Results The subjects with smoking hobby,diabetes history and higher concentrations of TC and LDL-C in the HICH group were obviously more than those in the control group (P＜0.05).As compared with those in the controls,the distributions of the APOEε3/4 and APOEε4 in the HICH group were significantly higher, and the distributions of the APOEε3/3 and APOEε3 in the HICH group were significantly lower (P＜0.05). The APOEε3/4 and APOEε4 carriers enjoyed higher percentages of onset age less than 45 years and superficial haematoma than A POEε3/3 and the A POEε3 carriers. The onset systolic blood pressure in APOEε3/4 and APOEε4 carriers was obviously lower than that in A POEε3/3 and A POEε3 carriers (P＜0.05). The plasma concentrations of LDL-C and TC in APOEε3/4 and APOEε4 carriers was significantly higher than those in APOEε3/3 and APOEε3 carriers (P＜0.05). Conclusion The APOE genotype influences the onset of HICH, and its influence factors included onset age, blood pressure,blood fat and bleeding part,which may concern with the cerebral artherosclerosis or amyloidosis.