ApoE与SLCO1B1基因多态性与老年脑梗死患者颅内动脉粥样硬化狭窄的相关性

Relationship between ApoE and SLCO1B1 gene polymorphisms and intracranial atherosclerotic stenosis in elderly patients with cerebral infarction

摘要:

目的 分析ApoE与SLCO1B1基因在老年脑梗死患者颅内动脉粥样硬化狭窄中的分布情况,及动脉狭窄程度与血脂的关系。方法 选取2018年2月至2019年2月北京中医药大学东方医院脑动脉粥样硬化患者200例为脑梗死组,以北美症状性颈动脉内膜剥脱术研究法分级标准划分动脉粥样硬化狭窄分级,其中无狭窄患者26例、轻度狭窄患者48例、中度狭窄患者45例、重度狭窄患者81例；并选取同时期健康人70名为对照组。对ApoE与SLCO1B1基因多态性采用基因芯片技术进行检测,分析不同颅内动脉狭窄程度中各基因分布情况,并总结影响老年脑梗死患者发生动脉狭窄的影响因素。采用SPSS 23.0统计软件进行数据分析。根据数据类型,组间比较分别采用LSD-t检验、χ²检验及方差分析。采用logistic回归分析对粥样动脉硬化狭窄的影响因素进行分析。结果 脑梗死组高血压史、糖尿病史、吸烟史、低密度脂蛋白胆固醇(LDL-C)、ApoE、SLCO1B1均高于对照组,而高密度脂蛋白胆固醇(HDL-C)低于对照组(P＜0.05)。ApoE中ε4、ε3/ε3动脉硬化狭窄率最高,差异均有统计学意义(均P＜0.05)；SLCO1B1*1b与SLCO1B1*5基因型组合中1b/1b狭窄率最高,差异均无统计学意义(均P＞0.05)。随着动脉粥样硬化狭窄程度的加重,总胆固醇、酰油三酯、LDL-C浓度逐渐增加,HDL-C浓度逐渐下降(P＜0.05)。经logistic回归分析证实,LDL-C、ApoE ε4、ApoE ε3/ε3是老年脑梗死患者发生颅内粥样动脉硬化狭窄的危险因素。结论 LDL-C、ApoE ε4、ApoE ε3/ε3与颅内粥样动脉硬化狭窄具有相关性,而SLCO1B1基因及基因组合与颅内粥样动脉硬化狭窄不相关。

Abstract:

Objective To analyze the distribution of ApoE and SLCO1B1 genes in intracranial atherosclerotic stenosis in the elderly patients with cerebral infarction and investigate the relationship between the degree of arterial stenosis and blood lipids. Methods From February 2018 to February 2019,200 patients with cerebral atherosclerosis in Oriental Hospital of Beijing University of Chinese Medicine were selected, and atherosclerotic stenosis was classified according to the North American Symptomatic Carotid Endarterectomy Trial (no stenosis, mild stenosis, moderate stenosis, severe stenosis); ApoE and SLCO1B1 gene polymorphisms were detected by gene chip technology, the distribution of each gene in different degrees of intracranial artery stenosis was analyzed, and the factors affecting the occurrence of arterial stenosis in the elderly patients with cerebral infarction were summarized. SPSS 23.0 was used for statistical analysis. Data comparison between the two groups was performed using LSD-t test, χ² test or Fisher exact test depending on data type. Logistic regression analysis was used to analyze the influencing factors of atherosclerotic stenosis.Results The history of hypertension, diabetes mellitus, smoking, low-density lipoprotein cholesterol (LDL-C), ApoE, and SLCO1B1 in the cerebral infarction group were higher than those in the control group, while high-density lipoprotein cholesterol (HDL-C) was lower than in the control group (P<0.05). ApoE had the highest rate of atherosclerosis stenosis in ε4 and ε3/ε3, and the difference was significant (P<0.05). The 1b/1b stenosis rate in the combination of SLCO1B1*1b and SLCO1B1*5 genotypes was the highest, but the difference was not significant (P>0.05). With the aggravation of atherosclerotic stenosis, the concentration of total cholesterol, triglyceride, and LDL-C gradually increased, and the concentration of HDL-C gradually decreased (P<0.05). Logistic regression analysis confirmed that LDL-C, ApoE ε4, ApoE ε3/ε3 were risk factors for intracranial atherosclerotic stenosis in the elderly patients with CI. Conclusion LDL-C, ApoE ε4, ApoE ε3/ε3 are associated with intracranial atherosclerosis and stenosis, and SLCO1B1 gene and gene combination are not.