Nicoll J A, Burnett C, Love S, Graham D I, Dewar D, Ironside J W, Stewart J, Vinters H V
Department of Neuropathology, University of Glasgow, UK.
Ann Neurol. 1997 Jun;41(6):716-21. doi: 10.1002/ana.410410607.
From the somewhat conflicting published data on apolipoprotein E (apoE) genotype in hemorrhage due to cerebral amyloid angiopathy (CAA), it is unclear whether apoE genotype influences the risk of CAA-related hemorrhage independently of its association with concomitant Alzheimer's disease (AD). We determined the apoE genotypes of 36 patients presenting with cerebral hemorrhage associated with histologically confirmed CAA. The frequency of apoE epsilon 2 was 0.25 and the frequency of apoE epsilon 4 was 0.18. Patients with CAA-related hemorrhage and concomitant AD pathology (CERAD criteria, n = 17) had a high apoE epsilon 4 frequency, close to that in AD cases without hemorrhage. Patients in whom CAA-related hemorrhage occurred in the absence of significant AD pathology (n = 13) had an apoE epsilon 4 frequency somewhat lower than non-AD controls without hemorrhage. However, in CAA-related hemorrhage, the apoE epsilon 2 frequency was high regardless of whether significant AD pathology was present. We conclude that whereas possession of apoE epsilon 2 may be a risk factor for cerebral hemorrhage due to CAA, apoE epsilon 4 is a risk factor for concomitant AD but not an independent risk factor for CAA-related hemorrhage.
从关于载脂蛋白E（apoE）基因型与脑淀粉样血管病（CAA）所致出血的已发表数据中存在的一些相互矛盾之处来看，尚不清楚apoE基因型是否独立于其与伴发的阿尔茨海默病（AD）的关联而影响CAA相关出血的风险。我们确定了36例经组织学证实为CAA并伴有脑出血患者的apoE基因型。apoE ε2的频率为0.25，apoE ε4的频率为0.18。伴有CAA相关出血和伴发AD病理改变（CERAD标准，n = 17）的患者中apoE ε4频率较高，接近无出血的AD病例。在无明显AD病理改变的情况下发生CAA相关出血的患者（n = 13）中，apoE ε4频率略低于无出血的非AD对照。然而，在CAA相关出血中，无论是否存在明显的AD病理改变，apoE ε2频率都较高。我们得出结论，虽然携带apoE ε2可能是CAA所致脑出血的一个危险因素，但apoE ε4是伴发AD的危险因素，而不是CAA相关出血的独立危险因素。
