Liang Na, Jiang Feng, Wang Li, Liu Xiaoling, Jia Ruihua, Liu Minnv, Hu Jun
Department of Neurology, Shaanxi Provincial People's Hospital, No. 256 Youyi West Road, Xi'an, 710068, Shaanxi, China.
Sci Rep. 2025 Sep 2;15(1):32288. doi: 10.1038/s41598-025-16237-5.
Determine whether APOE gene polymorphism is associated with hypoperfusion intensity ratio (HIR) in acute ischemic stroke (AIS) patients with large vessel occlusion (LVO). Continuously reviewed hospitalized LVO-AIS patients. According to whether the patients carried APOE allele ε 4, they were divided into 2 groups: ε4 carriers and non-ε4 carriers. CTP assessed HIR and infarct core (IC) volume. Good collaterals were defined as HIR < 0.4 and poor collaterals were defined as HIR ≥ 0.4. The patients were divided into two groups based on their HIR value: the HIR < 0.4 group and the HIR ≥ 0.4 group. IC volume was a rCBF < 40% volume. NIHSS at admission assessed stroke severity. A total of 101 patients with LVO-AIS were enrolled, including 82 patients with HIR < 0.4 and 19 patients with HIR ≥ 0.4. Among the patients with HIR < 0.4, 10 were ε4 carriers (12.20%), while among those with HIR ≥ 0.4, 8 were ε4 carriers (42.11%). The proportion of ε4 carriers was significantly higher in the HIR ≥ 0.4 patients group (P = 0.006). In all enrolled patients, there were 83 non-ε4 carriers and 18 ε4 carriers. The IC volume in ε4 carriers was significantly higher than that in non-ε4 carriers (P = 0.003). The NIHSS score in ε4 carriers was significantly higher than that in non-ε4 carriers (P = 0.004). Binary logistic regression showed that APOE ε4 was an independent risk factor for poor collaterals (OR = 6.00, 95%CI: 1.80, 20.02, P = 0.004). Multiple linear regression showed HIR had a significant positive effect on IC volume (B = 167.70, P < 0.001) and NIHSS score (B = 8.53, P = 0.014). APOE ε4 is an independent risk factor for poor collaterals.
确定载脂蛋白E（APOE）基因多态性是否与伴有大血管闭塞（LVO）的急性缺血性卒中（AIS）患者的低灌注强度比（HIR）相关。持续纳入住院的LVO-AIS患者。根据患者是否携带APOE等位基因ε4，将他们分为两组：ε4携带者和非ε4携带者。采用CT灌注成像（CTP）评估HIR和梗死核心（IC）体积。将良好侧支循环定义为HIR＜0.4，不良侧支循环定义为HIR≥0.4。根据HIR值将患者分为两组：HIR＜0.4组和HIR≥0.4组。IC体积为相对脑血流量（rCBF）＜40%的体积。入院时的美国国立卫生研究院卒中量表（NIHSS）评估卒中严重程度。共纳入101例LVO-AIS患者，其中HIR＜0.4的患者82例，HIR≥0.4的患者19例。在HIR＜0.4的患者中，10例为ε4携带者（12.20%），而在HIR≥0.4的患者中，8例为ε4携带者（42.11%）。HIR≥0.4患者组中ε4携带者的比例显著更高（P = 0.006）。在所有纳入患者中，有83例非ε4携带者和18例ε4携带者。ε4携带者的IC体积显著高于非ε4携带者（P = 0.003）。ε4携带者的NIHSS评分显著高于非ε4携带者（P = 0.004）。二元逻辑回归显示，APOE ε4是不良侧支循环的独立危险因素（比值比[OR]=6.00，95%置信区间[CI]：1.80，20.02，P = 0.004）。多元线性回归显示，HIR对IC体积有显著正效应（回归系数[B]=167.70，P＜0.001）和NIHSS评分有显著正效应（B = 8.53，P = 0.014）。APOE ε4是不良侧支循环的独立危险因素。
