Dept. of Neurosurgery, Affiliated Hospital of Zunyi Medical College, Guizhou 563000, PR China.
Brain Res. 2010 Nov 29;1362:112-6. doi: 10.1016/j.brainres.2010.09.013. Epub 2010 Sep 22.
Cerebral vasospasm (CV) is the main complication of spontaneous subarachnoid hemorrhage (SAH), affecting clinical outcome of patients with SAH. Accumulating evidence indicates that apolipoprotein E (apoE protein, APOE gene) gene polymorphism is associated with prognosis of patients with SAH. The current study aimed to investigate the association of promoter polymorphism of APOE with CV in patients with SAH. One hundred and one patients with spontaneous SAH were involved in this study. Venous blood samples were collected to identify the promoter genotype of APOE by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). CV was judged by transcranial Doppler sonography (TCD) combined with patients' condition. Associations of APOE promoter polymorphism with CV after SAH were analyzed by χ(2) test, uni- and multivariate logistic regression analyses. In 101 patients, 42 of 87 patients (48.3%) with promoter -219T allele showed CV, which was significantly different from those with -219G allele (23/61, 37.7%, P=0.04). Uni- and multivariate logistic regression analyses also showed that promoter -219T was a risk factor to predispose CV after SAH. However, there was no significant association between promoter -491A/T (rs#449647) or -427C/T (rs#769446) polymorphisms and SAH induced CV (P>0.05). Our finding suggests that patients with APOE -219T promoter are apt to CV after spontaneous SAH.
颅内血管痉挛（CV）是自发性蛛网膜下腔出血（SAH）的主要并发症，影响 SAH 患者的临床预后。越来越多的证据表明载脂蛋白 E（apoE 蛋白，APOE 基因）基因多态性与 SAH 患者的预后相关。本研究旨在探讨 APOE 启动子多态性与 SAH 患者 CV 的关系。本研究纳入 101 例自发性 SAH 患者。采集静脉血样本，通过聚合酶链反应-限制性片段长度多态性（PCR-RFLP）鉴定 APOE 启动子基因型。通过经颅多普勒超声（TCD）结合患者病情判断 CV。采用卡方检验、单因素和多因素 logistic 回归分析 APOE 启动子多态性与 SAH 后 CV 的关系。在 101 例患者中，87 例患者中有 42 例（48.3%）启动子-219T 等位基因发生 CV，与-219G 等位基因（23/61，37.7%）明显不同（P=0.04）。单因素和多因素 logistic 回归分析也表明，启动子-219T 是导致 SAH 后 CV 的危险因素。然而，启动子-491A/T（rs#449647）或-427C/T（rs#769446）多态性与 SAH 诱导的 CV 无明显相关性（P>0.05）。我们的研究结果表明，APOE-219T 启动子的患者在自发性 SAH 后容易发生 CV。
