A Study Of The Relationship Between ApoE Genetic Polymorphism And Recurrence Of Cerebral Infarction

Objective: Cerebral infarction is a multi-factor and complex disease which with high recurrence rate and poor prognosis of patients with recurrent cerebral infarction.Therefore,to explore the etiology of cerebral infarction recurrence can better guide the secondary prevention strategy of cerebral infarction and reduce the recurrence rate of cerebral infarction.Apolipoprotein E(ApoE)is involved in lipid metabolism and cholesterol transport.Studies have confirmed that ApoE gene polymorphism is closely related to the incidence of cerebral infarction.However,whether the ApoE gene polymorphism is related to the recurrence of cerebral infarction has not yet been fully elucidated.Therefore,the purpose of this study is to explore the correlation between ApoE gene polymorphism and recurrence of cerebral infarction,and to provide a basis for early diagnosis and secondary prevention of cerebral infarction.Methods: From July 2018 to December 2019,102 cases of patients with recurrent cerebral infarction and 102 patients with initial cerebral infarction were collected.The etiology is large artery atherosclerotic cerebral infarction.According to the previous history of cerebral infarction,new neurological deficit symptoms appeared,and head MRI confirmed the presence of new infarct lesions to confirm the diagnosis of recurrent cerebral infarction.The grouping used a 1:1 pairing design,collecting 102 patients with recurrent cerebral infarction who were hospitalized at the same period(within 1 week)of and age,gender and risk factors matched initail cerebral infarction.At the same period 101 medical examiners whose risk factors matched those of recurrent cerebral infarction were selected as the control group.Using real-time quantitative PCR(Polymerase Chain Reaction,PCR)to detect ApoE genotype.Using the automatic biochemical analyzer to detected High-density lipoprotein(HDL),low-density lipoprotein(LDL),total cholesterol(Total Cholesterol,TC),triglyceride(TG)and triglyceride(TG)and blood sugar.The frequencies of ApoE alleles and genotypes in the three groups were compared,and the risk factors ofcerebral infarction were analyzed by regression.Results:1.Comparison of the three groups of ApoE alleles: The frequency of ?3 in the three groups was statistically significant(P<0.05).The frequency of ?3 in the recurrent cerebral infarction group was lower than that in the initial cerebral infarction group(P=0.001)and the control group(P=0.000).The frequency of ?3 in the initial cerebral infarction group was lower than that in the control group(P=0.005).Compared with the frequency of ?4 among the three groups,the difference was statistically significant(P<0.05).The frequency of ?4 in the recurrent cerebral infarction group was higher than that in the initial cerebral infarction group(P=0.000)and the control group(P=0.000).The frequency of ?4 in the initial cerebral infarction group was higher than that in the control group(P=0.000).2.Comparison of three groups of ApoE genotypes: Comparison of three groups of ?3/?3,the difference was statistically significant(P<0.05),in which the frequency of ?3/?3 in recurrent cerebral infarction group was lower than that in the initial recurrent cerebral infarction group(P=0.003),The frequency of ?3/?3 in relapse group was lower than that of the control group(P=0.000).Compared with the frequency of ?4/?4 among the three groups,the difference was statistically significant(P<0.05).The frequency of ?4/?4 in the recurrent cerebral infarction group was higher than that in the control group(P=0.003).Compared with the frequency of ?2/?3 among the three groups,the difference was statistically significant(P<0.05),and the frequency of ?2/?3 in the recurrent cerebral infarction group was lower than that in the control group(P=0.004).The frequency of?3/?4 in the three groups was statistically significant(P<0.05).The frequency of ?3/?4 in the recurrent cerebral infarction group was higher than that in the control group(P=0.000),and the frequency of ?3/?4 in the initial cerebral infarction group was higher than that in the control group(P= 0.016).3.Regression analysis showed that the ?4 allele is an independent risk factor for the initial and recurrence of cerebral infarction(OR=2.662,95%Cl: 1.557~4.552,P<0.05;OR=2.174,95%Cl: 1.429 ~ 3.307,P <0.05).The ?3 allele is a protective gene for the initial and recurrence of cerebral infarction(OR=0.546,95%Cl: 0.375 ~ 0.834,P<0.05;OR=0.509,95%Cl: 0.343~0.755,P<0.05).The ?3/?4 genotype is an independent risk factor for the initiation and recurrence of cerebral infarction(OR=2.796,95% Cl:1.122~6.971,P<0.05;OR=2.279,95% Cl:1.144~4.538,P<0.05).The ?3/?3 genotype is a protective gene for the initial and recurrence of cerebral infarction(OR=0.545,95% Cl:0.306~0.971,P<0.05;OR=0.367,95% Cl:0.193~0.697,P<0.05).Conclusion: ApoE ?4 allele and ?3/?4 genotype may be genetic susceptibility genes for cerebral infarction,ApoE ?4 allele and ?3/?4 genotype may be potential risk factors for recurrence of cerebral infarction,ApoE ?3 allele And ?3/?3 genotypes may be protective genes for cerebral infarction.