The Outcome Observation Of Brain Injury Patients With Different APOE Isoforms Treated By Oxiracetam Injection

objective:To explore the influence of apolipoprotein E (APOE) gene polymorphism on the outcome in acute moderate and severe traumatic brain injury treated by oxiracetam injection. Methods:Venous blood was collected at the time of admission to determine the APOE genotype by multiplex polymerase chain reaction-ligase detection reaction (PCR-LDR) in 78 patients who presented with acute moderate and severe traumatic brain injury,meanwhile,These patients were treated by oxiracetam injection within 48 hours.During treatment,other nootropics were forbidden. Glasgow coma scale (GOS),mini mental state examination(MMSE) and neurological outcome scale for traumatic brain injury (NOS-TBI) were determined before and after they received one-week treatment,for analyzing the relationship between APOE gene polymorphism and the outcome. Results:Three homozygotes(ε2/2,ε3/3,ε4/4) and two heterozygotes(ε2/3,ε3/4) were detected among 78 patients,andε2/3 isoform was not detected.ε3/3 is at the very most, however,ε2/2 is at least.up to 80.13%,ε3/3 accounts for the highest allele frequency.These gene phenotypes are divided into three groups(ε2/2+ε2/3,ε3/3,ε3/4+ε4/4).The GCS,MMSE are improved significantly, and NOS-TBI is decreased obviously before and after treatment. In comparison between groups,outcomes betweenε2/2+ε2/3 andε3/3 have not obvious differences,but visible differences present betweenε3/4+ε4/4 and preceding two groups.Conclusions:(DOxiracetam injection is effective in the treatment of acute moderate and severe traumatic brain injury.②Patients'APOE gene polymorphism could influence the outcome of oxiracetam injection.③The outcome is worse in patients with APOEε4 allele than in those without it. APOEε4 allele may be one of the reasons resulting this phenomenon.