摘要
目的探讨载脂蛋白E（apolipoprotein E,apoE代表载脂蛋白,APOE代表编码载脂蛋白的基因）基因多态性与动脉瘤性蛛网膜下腔出血（subarachnoid hemorrhage,SAH）后早期脑功能改变的相关性。方法于入院时收集79例动脉瘤性SAH患者的临床资料。分别于入院当天和发病后第3-5天行脑电图检查以评判脑功能。与第1次脑电图比较,如随访脑电图α波频率下降、慢波增多或波幅下降等判定为脑电图异常程度加重。反之,未出现上述情况者则判定为脑电图异常程度减轻。APOE基因多态性通过聚合酶链反应限制性片段长度多态性（PCR-RFLP）而确定。结果在17例APOEε4等位基因携带者中有10例（58.8%）脑电图异常程度加重,明显高于非ε4携带者（29.0%,P=0.023）。而ε2、ε3携带者中出现脑电图异常程度加重比例与非ε2、ε3携带者比较,差异无统计学意义（P〉0.05）。单因素Logistic回归分析提示高Fisher分级（P=0.028,OR=2.917,95%CI=1.124-7.572）及ε4（P=0.027,OR=3.492,95%CI=1.150-10.604）均是动脉瘤性SAH后脑电图异常程度加重的危险因素。调整临床资料后行多因素Logistic回归分析,发现APOEε4与脑电图变化的关系更为显著（P=0.007,OR=5.741,95%CI=1.625-20.280）。结论APOEε4等位基因是动脉瘤性SAH后早期脑功能损伤加重的危险因素,同时其也可能参与了SAH后早期脑损伤。
Objective To explore the association of APOE gene polymorphism with the brain function in the early stage of aneurysmal subarachnoid hemorrhage（SAH）.MethodsTotally 79 patients with aneurysmal SAH admitted in our hospital from March 2008 to April 2009 were recruited and their clinical data were collected.Electroencephalography（EEG）was recorded on admission and in 3 to 5 d after onset to assess the change of brain function of the patients in acute stage of SAH.The result of the second EEG recording was defined as EEG deterioration if the decrease in alpha wave frequency,increase in slow wave or decline in amplitude were observed when compared with the first EEG recording.The APOE polymorphism was determined by polymerase chain reaction-restriction fragment length polymorphism（PCR-RFLP）.ResultsTen of 17 patients with APOE ε4（58.8%）showed the deteriorated EEG,which was significantly different from those without APOE ε4（18 of 62 patients,29.0%,P=0.023）.However,neither the presence of ε2 nor of ε3 was significantly different from those absent of it（P〉0.05）.Univariate logistic regression analyses showed that both high Fisher grade（P=0.028,OR=2.917,95%CI=1.124 to 7.572）and APOEε4（P=0.027,OR=3.492,95%CI=1.150 to 10.604）were risk factors to EEG aggravation after aneurysmal SAH.The association of APOEε4 for deteriorated EEG was more significant after adjustment for age,gender,Hunt-Hess grade on admission,and Fisher grade（P=0.007,OR=5.741,95%CI=1.625 to 20.280）.ConclusionOur findings suggest that the APOEε4 allele is a risk factor to brain function aggravation in the early stage of aneurysmal SAH,and it may contribute to early brain injury after SAH.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2010年第7期700-703,共4页
Journal of Third Military Medical University
关键词
载脂蛋白E类
蛛网膜下腔出血
脑电图
早期脑损伤
流行病学
分子
apolipoprotein E
subarachnoid hemorrhage
electroencephalogram
early brain injury
epidemiology
molecular
