摘要
目的 近年来许多研究证明多种疾病与载脂蛋白E(APOE)基因多样性相关,本文旨在探讨APOE基因在颅内血管狭窄引起的急性缺血性卒中的预测价值及评估其预后的作用。方法 收集2022年1月-2023年12月中国科学技术大学附属第一医院收治的急性缺血性脑卒中(AIS)患者511例,根据是否有颅内动脉狭窄将其分成颅内动脉狭窄(ICAS)组(317例)和非颅内动脉狭窄(NCAS)组(194例)及6个月随访时根据是否携带APOE-ε4将其分为携带ε4基因(213例)组和非携带ε4(298例)组,分析年龄、性别、合并症、血脂、载脂蛋白E(包括等位基因分型)和脂蛋白a的差异,并进行血管壁高分辨率磁共振成像。术后6个月随访患者的功能转归,随访高清血管壁成像结果。结果 ICAS组的APOE浓度显著低于NCAS组(r=0.481,P<0.01)。携带APOE-ε4基因的患者中45.54%(97/213)和未携带APOE-ε4基因的患者中16.11%(48/298)在治疗结束6个月随访时预后不良(OR=4.622,95%CI:3.512~6.091,P<0.01)。结论 血浆APOE水平低是ICAS引起的急性缺血性卒中的高危因素,携带APOE-ε4基因是AIS患者功能预后不良的高危因素。APOE-ε4基因型联合高分辨率血管壁成像在预测急性缺血性卒中发生及评估功能转归方面具有一定的应用价值。
ObjectiveIn recent years,many studies have shown that many diseases are associated with apolipoprotein E(APOE)gene diversity.The aim of this study is to investigate the predictive value of the APOE gene in acute ischemic stroke(AIS)caused by intracranial vascular stenosis and its role in evaluating its prognosis.MethodsA total of 511 patients with acute ischemic stroke admitted to the First Affiliated Hospital of the University of Science and Technology of China from January 2022 to December 2023 were collected.According to the presence or absence of intracranial artery stenosis,they were divided into the intracranial artery stenosis(ICAS)group(317 cases)and the non-intracranial artery stenosis(NCAS)group(194 cases).At the 6-month follow-up,According to whether they carried the APOE-ε4 gene or not,they were further divided intoε4 carrier group(213 cases)and non-ε4 carrier group(298 cases).Variable such as age,gender,comorbidities,blood lipids,lipoprotein,apolipoprotein E(including allele typing),and lipoprotein A were analyzed,along with highresolution magnetic resonance imaging of the vessel wall.Followed up evaluations were conducted 6 months after the operation,with results tracked via highdefinition vessel wall imaging.ResultsThe plasma APOE concentration in the ICAS group was significantly lower than that in the nonintracranial artery stenosis group(r=0.481,P<0.01).Among theε4 carriers,97/213(45.54%)had a poor prognosis,while 48/298(16.11%)of non-ε4 carriers experienced poor prognosis at the end of treatment and after 6 months of followup,with a significant difference(OR=4.622,95%CI:3.512-6.091,P<0.01).ConclusionLow plasma APOE levels are a risk factor for acute ischemic stroke caused by ICAS,and the APOE-ε4 gene is associated with poor functional prognosis in AIS patients.Combining the APOE-ε4 genotype with highresolution vessel wall imaging may be valuable in predicting acute ischemic stroke and evaluating functional outcomes.
作者
王朋
音大为
何野
胡翀
孙文
朱余友
WANG Peng;YIN Dawei;HE Ye;HU Chong;SUN Wen;ZHU Yuyou(Department of Radiology,the First Affiliated Hospital of University of Science and Technology of China,Hefei,Anhui 230036,China;不详)
出处
《中华全科医学》
2024年第9期1475-1478,1591,共5页
Chinese Journal of General Practice
基金
国家自然科学基金面上项目(62371433)。
