【摘要】 目的:研究腔隙性梗死(腔梗)与皮质、皮质下梗死(皮梗)患者的载脂蛋白E(ApoE)基因多态性分布的差异及与多种血管危险因素相关性的差异。方法:设腔梗组(81例)和皮梗组(87例),以调查表方式调查患者一般状况及血管危险因素;晨起空腹采血分离血清,测血糖、血脂,并以聚合酶链反应-限制性片段长度多态性(PCR-RFLP)检测法测定患者ApoE基因型。结果:①2组基因分布:腔梗组ε3/4+ε4/4型频率(25.9%)明显高于皮梗组(11.5%);ε4频率(17.9%)高于皮梗组(9.8%),P均<0.05。ε3/4及ε4/4的携带者发生腔梗危险度高于皮梗,OR=2.77,95%CI1.21~6.38,P<0.05。②腔梗组高血压患者多于皮梗组,高血压患者患腔梗,危险度大于皮梗,OR=2.02,95%CI1.07~3.80,P<0.05,。腔梗组血浆总胆固醇水平高于皮梗组,P<0.05。结论:ε3/4和ε4/4携带者发生腔梗的危险度大于皮梗,这可能和ε4增高TC水平,加速脑小动脉粥样硬化进程有关。更多还原

【Abstract】 Aim: To study the difference of apolipoprotein（ApoE） genotypes between patients with lacunar infarction and patients with cortical,subcortical infarction. Methods: The general condition and risk factors were investigated, the blood glucose and lipids were dertermined, and the ApoE genomic polymorphism was detected using PCR-RFLP method in 81 patients with lacunar infarction and 87 patients with cortical,subcortical infarction.Results: The frequency（25.9%） of ε 3/4 +ε 4/4 and ε₄ allele （17.9%） in lacunar infarction group were higher than those in cortical,subcortical infarction group （11.5%, 9.8%,respectively）, all P<0.05. and among persons with ε 3/4 + ε 4/4 the risk of lacunar infarction was higher than that of cortical,subcortical infarction, OR=2.77,95%CI 1.21～6.38,P<0.05. The patients with hypertension in lacunar infartion group were more than those in cortical,subcortical infarction group,and the risk of lacunar infarction was higher than that of cortical,subcortical infarction in patients with hypertension,OR=2.02,95%CI 1.07～3.80,P<0.05.The total cholesterol （TC） in lacunar infarction group was higher than that in cortical,subcortical infarction group,P< 0.05. Conclusion: Among persons with ε 3/4 +ε 4/4 , the risk of lacunar infaction is higher than that of cortical,subcortical infarction, which may involve in ε₄ increasing TC level and promoting atherosclerosis process.更多还原