Abstract：Objective To investigate the relationships between Apolipoprotein E (ApoE) gene polymorphism and the initial acute ischemic stroke (AIS) while assessing its predictive value of short-term prognosis.Methods A total of 445 patients with AIS treated between January 2016 and January 2018 were selected and another 363 medical examinees were enrolled as controls in the study. Blood lipids, blood glucose and other related biochemical indicators were tested by the automatic biochemical analyzer. The ApoE genotype was detected by real-time fluorescent quantitative PCR. The enrolled AIS patients were treated according to China’s guidelines for acute ischemic stroke, and were evaluated using mRS (Modified Rankin Scale) within 24 hours of hospitalization and 6 months after discharge. Chi-square test was used to analyze the correlations between ApoE genotype and AIS prognosis.Results The ApoE genotype distribution of the 445 initial AIS patients was significantly different from that of the normal control group (χ2=13.31, P<0.01). For patients with immediate mRS>2 admission, ApoE genotyping was significantly different from that of the mRS ≤2 patients (χ2=7.70, P<0.01). Six months after discharge, patients with poor short-term prognosis (mRS>2) had different ApoE genotypes from patients with good prognosis (mRS≤2,χ2=11.31, P<0.01).Conclusions The ApoE gene polymorphism is closely related to the occurrence of initial AIS, which may be a predictor of poor short-term prognosis of AIS.
杨春梅, 刘圆圆. 载脂蛋白E基因多态性与初发急性缺血性脑卒中的相关性及其对近期预后的影响[J]. 武警医学, 2019, 30(6): 518-520.
YANG Chunmei LIU Yuanyuan. Correlations between apolipoprotein E gene polymorphism and initial acute ischemic stroke and its impact on short-term prognosis of AIS. Med. J. Chin. Peop. Armed Poli. Forc., 2019, 30(6): 518-520.
Feigin V L, Lawes C M, Bennett D A, et al. Stroke epidemiology: a review of population-based studies of incidence, prevalence, and case-fatality in the late 20th century [J]. Lancet Neurol, 2003, 2(1):43-53.
[2]
Lopez A D, Mathers C D, Ezzati M, et al. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data [J]. Lancet, 2006, 367(9524):1747-1757.
[3]
Tuttolomondo A, Pedone C, Pinto A, et al. Predictors of outcome in acute ischemic cerebrovascular syndromes: the GIFA study [J]. Int J Cardiol, 2008, 125(3):391-396.
[4]
Ganan A, Corella D, Guillen M, et al. Frequencies of apolipoprotein A4 gene polymorphisms and association with serum lipid concentrations in two healthy Spanish populations [J]. Hum Biol, 2004, 76(2):253-266.
[5]
Wei L K, Au A, Menon S, et al. PolymorphAISms of MTHFR, eNOS, ACE, AGT, ApoE, PON1, PDE4D, and ischemic Stroke: Meta-Analysis [J]. J Stroke Cerebrovasc Dis, 2017, 26(11):2482-2493.
[6]
Huang Y, Liu X Q, Rall S C Jr, et al. Overexpression and accumulation of apolipoprotein E as a cause of hypertriglyceridemia [J]. J Biol Chem,1998,273(41):26388-26393.
[7]
Mahley R W, Rall S C Jr. Apolipoprotein E: far more than a lipid transport protein [J]. Ann Rev Genom Hum Genet, 2000,1: 507-537.
[8]
Phillips M C. Apolipoprotein E isoforms and lipoprotein metabolism [J]. IUBMB Life, 2014, 66(9): 616-623.
[9]
Hallman D M, Boerwinkle E, Saha N, et al. The apolipoprotein E polymorphism: a comparison of allele frequencies and effects in nine populations [J]. Am J Hum Genet, 1991, 49(2): 338-349.
[10]
Tonk M, Haan J. A review of genetic causes of ischemic and hemorrhagic stroke [J]. J Neurol Sci, 2007, 257(1-2):273-279.
[11]
McCarron M O, Delong D, Alberts M J. APOE genotype as a risk factor for ischemic cerebrovascular disease: a meta-analysis [J]. Neurology, 1999, 53(6):1308-1311.
[12]
Alberts M J, Graffagnino C, McClenny C, et al. ApoE genotype and survival from intracerebral haemorrhage [J]. Lancet,1995, 346(8974):575.
[13]
Wang Q Y, Wang W J, Wu L, et al. Meta-analysis of APOE epsilon2/epsilon3/epsilon4 polymorphism and cerebral infarction [J]. J Neural Transm (Vienna), 2013,120(10):1479-1489.
2019, Vol. 30 
