载脂蛋白E多态性与脑梗死及脂类代谢关系的研究

目的:探讨载脂蛋白E(ApoE)多态性与脑梗死及脂类代谢的关系。方法:缺血性脑梗死组110例,健康对照组60例。ApoE表型采用等电聚焦(IEF)电泳及免疫印迹(Westernblotting)技术测定,血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)采用酶法测定,低密度脂蛋白胆固醇(LDL-C)按Fridwald公式计算,ApoAⅠ、ApoB用火箭电泳法测定,ApoE、脂蛋白(a)用ELISA法测定。结果:脑梗死组ApoEε4等位基因表达显著高于对照组(P＜0.05);脑梗死组TC、TG、LDL-C、ApoB、ApoE、Lp(a)水平显著高于对照组(P＜0.05或P＜0.01),ApoAⅠ、HDL-C显著低于对照组(P＜0.05);脑梗死组各等位基因(ε2、ε3、ε4)之间血脂水平比较;含ε4等位基因者,TC、LDL-C、ApoB、Lp(a)水平高于含ε3者(P＜0.05),HDL-C、ApoAⅠ较低(P＜0.05);含ε2等位基因者,TG、HDL-C、ApoAⅠ、ApoE高于含ε3者(P＜0.05),TC、LDL-C、ApoB较低(P＜0.05)。结论:ApoEε4等位基因与脑梗死发病有关,ε2、ε4等位基因与脑硬死患者的脂类代谢改变有关。

Association between apolipoprotein E polymorphism and lipid metabolism in patients with cerebral infarction

AIM:To study the relationship between ApoE polymorphism and lipid metabolism of patients with cerebral infarction. METHODS:ApoE phenotype was determined in 110 patients with cerebral infarction and 60 normal controls by isoelectric focusing and immunoblotting. The TC, TG and HDL-C levels in serum of these subjects were measured with enzymes methods, ApoA I and ApoB levels with rocket immunoelectrophoresis methods, ApoE and Lp(a) levels with ELISA methods. RESULTS:The differences of the ApoE polymorphism distribution and ApoE allele frequencies (P＜0.05) occurred between two groups. The frequence of ApoE ε4 allele in patients with cerebral infarction was significantly higher than those in the normal controls (P＜0.05). However, ApoE 3/3 phenotypes was significantly lower (P＜0.05). Comparison of values of serum lipid with various ApoE phenotyoe among patients with cerebral infarction revealed that there was correlation between ApoE polymorphism and TC(P＜0.05), TG(P＜0.05), HDL-C(P＜0.05), LDL-C(P＜0.05), ApoA I(P＜0.05), ApoB(P＜0.05), ApoE(P＜0.05)and Lp(a)(P＜0.05). Patients carrying ε4 were associated with increased TC, LDL-C, ApoB and Lp(a), while those with ε2 were assiociated with decreased TC, LDL-C, and ApoB. Patients carrying ε2 were associated with increased TG, HDL-C, ApoAⅠ, and ApoE.CONCLUSIONS:ApoEε4 allele was associated with the development of cerebral infarction. ApoE polyphorphism affects lipid metabolism of cerebral infarction patients.