摘要
目的研究急性脑梗死(acute cerebral infarction,ACI)患者ApoE基因多态性分布特点,并探讨与脂蛋白相关磷脂酶A_2(lipoprotein-associated phospholipase A_2,Lp-PLA_2)表达的相关性。方法采用病例对照研究方法,选取2015年7月至2017年6月聊城市第三人民医院神经内科112例ACI患者和59例年龄匹配的查体健康者。应用核酸探针杂交芯片技术检测ApoE的基因分型,采用上转发光技术测定血清Lp-PLA_2。结果对照组ApoE的E2、E3和E4等位基因频率分别为21.19%、73.73%和5.08%。Apo E基因型频率符合Hardy-Weinberg平衡。ACI组与对照组比较,E2等位基因频率(6.25%)低于对照组(21.19%),差异具有统计学意义(P<0.01);ε2/2、ε2/3基因分型均低于对照组,差异具有统计学意义(P<0.05);ε3/4基因分型高于对照组,差异具有统计学意义(P<0.05)。Lp-PLA_2表达对照组(106.16±38.85 ng/ml)与ACI组(146.39±57.90 ng/ml)差异有统计学意义(P<0.01)。两组间E4等位基因与非E4等位基因Lp-PLA_2浓度两两比较:对照组E4等位基因携带者与ACI组非E4患者比较(P=0.153),差异无统计学意义(P>0.05);其他各组间差异均有统计学意义(P<0.01)。Lp-PLA_2表达与ACI患者ROC曲线诊断价值分析:AUC值为0.790,95%CI(71.9,86.1),临床诊断临界点为123.01 ng/ml,敏感度为67.8%,特异度为69.6%,Lp-PLA_2表达水平对判断ACI的发生有统计学意义(P<0.01)。Logistic回归分析显示:Lp-PLA_2与ApoE E4等位基因均为ACI诊治的危险因素。结论 ApoE E4等位基因携带为ACI的风险因子,Lp-PLA_2表达与ACI患者密切相关;检测ApoE基因型及血清Lp-PLA_2表达对诊断ACI发生有一定的临床意义。
Objective To investigate the distribution of ApoE gene polymorphism in patients with acute cerebral infarction（ACI） and to explore the its correlation with the expression of lipoprotein-associated phospholipase A2（Lp-PLA2）. Methods A case-control study was conducted in 112 ACI inpatients that visited the Department of Neurology, the Third People′s Hospital of Liaocheng from July 2015 to June 2017 and 59 age-matched healthy subjects were included as control. Nucleic acid probe hybridization chips were used to detect the genotypes of ApoE and serum Lp-PLA2 was measured by the up-converting luminescence technique. Results The allele frequencies of ApoE E2, E3 and E4 in the control group were 21.19%, 73.73% and 5.08%, respectively. The genotype frequency of ApoE conforms to the balance of Hardy-Weinberg. The frequency of E2 allele in ACI group（6.25%） was significantly lower than that in control group（21.19%）（P〈0.01）. The genotypes of ε2/2 and ε2/3 in ACI group were significantly lower than those in control group（P〈0.05）, and the genotype of ε3/4 in ACI group was higher than that in control group（P〈0.05）. Significantly different levels of the serum Lp-PLA2 were found between the two group（106.16±38.85 ng/ml, in control group and 146.39±57.90 ng/ml in, ACI group, P〈0.01）. There was no significant difference between the serum level of Lp-PLA2 in the E4 carriers of the control group and in non-E4 carriers of the ACI group（P〉0.05）, while there were significant differences among the other groups（P〈0.01）. The AUC value of serum Lp-PLA2 was 0.790（95%CI 71.9-86.1）. The critical point of clinical diagnosis is 123.01 ng/ml, the sensitivity was 67.8%, the specificity was 69.6%, and the expression level of Lp-PLA2 was significant（P〈0.01） for judging the occurrence of ACI. Logistic regression analysis showed that Lp-PLA2 and ApoE E4 alleles were both risk factors for the diagnosis and treatment of ACI. Conclusion The ApoE E4 allele is a risk factor for acute cere
作者
赵顺锋
王建红
许红霞
胡慧营
宋来春
常立国
郭振伟
Zhao Shunfeng;Wang Jianhong;Xu Hongxia;Hu huiying;Song Laichun;Chang Liguo;Guo Zhenwei(Department of Clinical Laboratory,the Third People＇s Hospital of Liaocheng,Treatment of Cardio-cerebral Vascular Diseases,Shandong 252000,China)
出处
《中华临床实验室管理电子杂志》
2018年第3期140-144,共5页
Chinese Journal of Clinical Laboratory Management(Electronic Edition）
基金
聊城市科技发展计划项目(2014GJH17)
关键词
急性脑梗死
载脂蛋白E
基因多态性
等位基因
脂蛋白相关磷脂酶A2
Acute cerebral infarction
Apolipoprotein E
Gene polymorphism
Allele
Lipoprotein-associated phospholipase A2
