ApoE基因多态性及血清Lp-PLA2水平与血液透析患者心血管疾病的相关性研究

摘要/Abstract

摘要： 目的：分析载脂蛋白E(apolipoprotein E，ApoE)基因多态性及血清脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2，Lp-PLA2)水平与血液透析(hemodialysis，HD)患者心血管疾病(cardiovascular disease，CVD)的相关性。方法：回顾性分析2018年1月至2020年1月于我院接受HD治疗的226例肾功能受损患者的临床资料，将合并CVD的166例患者作为观察组，未合并CVD的60例患者为对照组。检测两组患者肾功能相关指标[血肌酐( Scr)、血尿素氮(BUN)]、血脂[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]及血清Lp-PLA2水平，用 PCR法检测ApoE基因多态性，并分析其与HD患者CVD的关系。结果：观察组患者血清TG、LDL-C、SCr、BUN、Lp-PLA2水平均高于对照组(P<0.05)，HDL-C水平低于对照组(P<0.05)。根据检测结果，观察组患者基因型ε3/ε3占比、等位基因ε3频率、E3型占比均低于对照组，ε3/ε4占比、ε4频率和E4型占比均高于对照组(P<0.05)。Logistic回归分析显示，Lp-PLA2水平、基因型ε3/ε3、ε3/ε4和表现型E3均为HD患者发生CVD的影响因素(OR=0.943、3.320、0.224、8.607，P<0.05)。结论：接受HD治疗的肾功能受损患者血清Lp-PLA2水平明显异常，血液ApoE基因呈多态性分布，基因型和表现型均会影响CVD的发生，临床上可针对该类基因型和Lp-PLA2水平异常患者进行早期预防和针对性治疗，以降低CVD发生率。

关键词: font-size:medium, ">血液透析；心血管疾病；ApoE基因；脂蛋白相关磷脂酶A2

Abstract: Objective：To analyze the relationship between apolipoprotein E(ApoE) gene polymorphism and serum lipoprotein-associated phospholipase A2(Lp-PLA2) level and cardiovascular disease (CVD) in hemodialysis(HD) patients. Methods：The clinical data of 226 patients with impaired renal function who received HD treatment in our hospital from January 2018 to January 2020 were retrospectively amalyzed. 166 patients with CVD were included as the observation group and 60 patients without CVD were included as the control group. The levels of renal function indexes [serum creatinine(Scr)， blood urea nitrogen(BUN)]， blood lipids [total cholesterol(TC)， triglyceride(TG)， low density lipoprotein cholesterol(LDL-C)， high density lipoprotein cholesterol(HDL-C)]and serum Lp-PLA2 of the two groups of patients were detected.The polymorphism of ApoE gene was detected by PCR method， and the relationship between it and CVD in HD patients was analyzed.Results：The Serum TG， LDL-C， SCr， BUN and Lp-PLA2 levels of patients in the observation group were higher than those in the control group，while the level of HDL-C of patients in the observation group was lower than that in the control group (P<0.05). According to the detection results， the proportion of ε3/ε3 genotype， frequency of ε3 allele and proportion of phenotype E3 in the observation group were lower than those in the control group， while the proportion of ε3/ε4 genotype， frequency of ε4 allele and proportion of phenotype E4 in the observation group were higher than those in the control group (P<0.05). Logistic regression analysis showed that serum Lp-PLA2 level，ε3/ε3 genotype， ε3/ε4 genotype and phenotype E3 were the influencing factors of CVD of HD patients (OR=0.943， 3.320， 0.224， 8.607， P<0.05).Conclusion：The serum Lp-PLA2 level of patients with impaired renal function receiving HD treatment is obviously abnormal.Their blood ApoE gene is polymorphic distribution， and genotype and phenotype can affect the occurrence of CVD. Clinical early prevention and targeted treatment can be carried out for patients with this type of genotype and abnormal Lp-PLA2 level， so as to reduce the incidence of CVD.

Key words: font-size:medium, ">Hemodialysis； Cardiovascular diseases； ApoE gene； Lipoprotein-associated phospholipase A2

中图分类号:

王露, 张春莹. ApoE基因多态性及血清Lp-PLA2水平与血液透析患者心血管疾病的相关性研究[J]. 中国医药导刊, 2022, 24(12): 1184-1198.

WANG Lu, ZHANG Chunying. Relationship between ApoE Gene Polymorphism and Serum Lp-PLA2 Level and Cardiovascular Disease in Hemodialysis Patients[J]. CHINESE JOURNAL OF MEDICINAL GUIDE, 2022, 24(12): 1184-1198.

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