Lancet Neurology:银杏叶不能预防阿尔茨海默病

2012-09-11 陈蓉 Lancet Neu

 MedSci评论:  在过去几十年内,不少人认为银杏作为一种古老的树种,它的叶子中含有大量的银杏总黄酮,而黄酮类物质往往具有促进血液循环和抗氧化作用,因此银杏提取物一度用来抗衰老,预防老年性痴呆,是老人追逐的保健品。但是,从临床循证的证据上看,缺乏高等级的循证证据,因此医学界一直对此既不否定也不肯定。而这篇研究,是高等级的循证证据,直接回答了过去的疑问。当然,未来还有必

 MedSci评论:
 在过去几十年内,不少人认为银杏作为一种古老的树种,它的叶子中含有大量的银杏总黄酮,而黄酮类物质往往具有促进血液循环和抗氧化作用,因此银杏提取物一度用来抗衰老,预防老年性痴呆,是老人追逐的保健品。但是,从临床循证的证据上看,缺乏高等级的循证证据,因此医学界一直对此既不否定也不肯定。而这篇研究,是高等级的循证证据,直接回答了过去的疑问。当然,未来还有必要进行补充研究,例如对于60岁以上老人,或更长时间的随访结果如何?另外,除银杏叶外,还有其它很多植物提取物,也常用于预防一些疾病,它们真的有效吗?
 
       以往人们认为,银杏叶补充剂可以帮助改善记忆力,甚至有延缓脑细胞老化、避免阿尔兹海默病的功效。不过根据法国最新的研究发现,服用银杏叶补充剂根本没有改善记忆的的功效,对于已经开始发展的疾病,如阿尔兹海默病、记忆力退化等,也没有减缓其疾病进程的迹象。对此,学者指出,减缓记忆退化最有效的方法还是维持良好的生活习惯,如饮食均衡、戒烟和控制胆固醇等。

  法国的研究人员在五年内针对2854名70岁以上的老年人进行研究,受试者分成两组,其中一组固定每日服用120毫克的银杏叶补充剂,另一组人只是给予安慰剂,来观察受试者在记忆、大脑功能和是否有痴呆情形出现。五年后,有服用银杏叶补充剂组和服用安慰剂组,各有4%及5%的人被诊断罹患阿尔兹海默病,比例几乎不相上下,且研究人员也没有发现两组受试者在死亡、其他疾病或卒中的发生上有显著的差异,证明银杏叶补充剂无效。这项结果被刊登在Lancet Neurology期刊上,且这项研究结果与2009年美国发表的研究结果无异。

  研究领导人Bruno Vellas 教授表示,这是一项欧洲有史以来最大规模的研究,且过去也没有有效的研究指出,银杏叶补充剂具有改善记忆力的功效,服用银杏叶补充剂对抗记忆衰退,不过是在浪费时间。此外,Bruno Vellas 教授也说,罹患阿尔兹海默病的患者将会越来越多,在2050年前一定要关注预防的议题。而南加州大学阿尔兹海默病研究中心的Lon Schneider教授直言,有些人仍对银杏叶补充剂的疗效深信不移,这是相当"不幸"的一件事。

  据了解,有人认为银杏含有黄酮类成分,能够改善血液循环、增加血液灌流,其抗氧化的特性,更能制衡体内有害的化学物质,并增加中枢神经系统所获取的氧气及养分。不过根据法国这一项大规模的研究结果,银杏叶补充剂似乎没有这项功效,学者则是建议公众,改善生活习惯、戒烟、均衡摄取营养等,才能有效帮助维持身体健康,并达到减少退化的目标。

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    2013-07-25 howi
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    2013-01-23 yinhl1978
  4. [GetPortalCommentsPageByObjectIdResponse(id=1827460, encodeId=d748182e46071, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Thu Jul 25 01:49:00 CST 2013, time=2013-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1641252, encodeId=ecb3164125286, content=<a href='/topic/show?id=bb59966443f' target=_blank style='color:#2F92EE;'>#银杏叶#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96644, encryptionId=bb59966443f, topicName=银杏叶)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a91f22772330, createdName=12498bf3m32暂无昵称, createdTime=Wed Jan 23 00:49:00 CST 2013, time=2013-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1999216, encodeId=e64b199921643, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Wed Jan 23 06:49:00 CST 2013, time=2013-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1816546, encodeId=4013181654685, content=<a href='/topic/show?id=17b59e77626' target=_blank style='color:#2F92EE;'>#阿尔茨#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97776, encryptionId=17b59e77626, topicName=阿尔茨)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Bnia2EtH2IvyBtniaWHPQOYAicsN3IAL1ZuPV7qyALcdCiawRJdEiafMxWTxzERQW7eeKg8HfCKCRK2CJicy073C4RJg/132, createdBy=464b2500186, createdName=ms1948154235210413, createdTime=Mon Jun 10 18:49:00 CST 2013, time=2013-06-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1817569, encodeId=05c2181e56919, content=<a href='/topic/show?id=4c9f9e777ac' target=_blank style='color:#2F92EE;'>#阿尔茨海#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97777, encryptionId=4c9f9e777ac, topicName=阿尔茨海)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Sat Dec 15 21:49:00 CST 2012, time=2012-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1469923, encodeId=78ca146992345, content=<a href='/topic/show?id=45a79e7788c' target=_blank style='color:#2F92EE;'>#阿尔茨海默#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97778, encryptionId=45a79e7788c, topicName=阿尔茨海默)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c5917090900, createdName=yhj-time, createdTime=Thu Sep 13 01:49:00 CST 2012, time=2012-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=4743, encodeId=6e884e43ae, content=原来如此,现在才了解了。谢谢这个专业网站, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=wumin, createdTime=Tue Sep 11 17:18:00 CST 2012, time=2012-09-11, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1827460, encodeId=d748182e46071, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Thu Jul 25 01:49:00 CST 2013, time=2013-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1641252, encodeId=ecb3164125286, content=<a href='/topic/show?id=bb59966443f' target=_blank style='color:#2F92EE;'>#银杏叶#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96644, encryptionId=bb59966443f, topicName=银杏叶)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a91f22772330, createdName=12498bf3m32暂无昵称, createdTime=Wed Jan 23 00:49:00 CST 2013, time=2013-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1999216, encodeId=e64b199921643, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Wed Jan 23 06:49:00 CST 2013, time=2013-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1816546, encodeId=4013181654685, content=<a href='/topic/show?id=17b59e77626' target=_blank style='color:#2F92EE;'>#阿尔茨#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97776, encryptionId=17b59e77626, topicName=阿尔茨)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Bnia2EtH2IvyBtniaWHPQOYAicsN3IAL1ZuPV7qyALcdCiawRJdEiafMxWTxzERQW7eeKg8HfCKCRK2CJicy073C4RJg/132, createdBy=464b2500186, createdName=ms1948154235210413, createdTime=Mon Jun 10 18:49:00 CST 2013, time=2013-06-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1817569, encodeId=05c2181e56919, content=<a href='/topic/show?id=4c9f9e777ac' target=_blank style='color:#2F92EE;'>#阿尔茨海#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97777, encryptionId=4c9f9e777ac, topicName=阿尔茨海)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Sat Dec 15 21:49:00 CST 2012, time=2012-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1469923, encodeId=78ca146992345, content=<a href='/topic/show?id=45a79e7788c' target=_blank style='color:#2F92EE;'>#阿尔茨海默#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97778, encryptionId=45a79e7788c, topicName=阿尔茨海默)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c5917090900, createdName=yhj-time, createdTime=Thu Sep 13 01:49:00 CST 2012, time=2012-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=4743, encodeId=6e884e43ae, content=原来如此,现在才了解了。谢谢这个专业网站, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=wumin, createdTime=Tue Sep 11 17:18:00 CST 2012, time=2012-09-11, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1827460, encodeId=d748182e46071, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Thu Jul 25 01:49:00 CST 2013, time=2013-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1641252, encodeId=ecb3164125286, content=<a href='/topic/show?id=bb59966443f' target=_blank style='color:#2F92EE;'>#银杏叶#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96644, encryptionId=bb59966443f, topicName=银杏叶)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a91f22772330, createdName=12498bf3m32暂无昵称, createdTime=Wed Jan 23 00:49:00 CST 2013, time=2013-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1999216, encodeId=e64b199921643, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Wed Jan 23 06:49:00 CST 2013, time=2013-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1816546, encodeId=4013181654685, content=<a href='/topic/show?id=17b59e77626' target=_blank style='color:#2F92EE;'>#阿尔茨#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97776, encryptionId=17b59e77626, topicName=阿尔茨)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Bnia2EtH2IvyBtniaWHPQOYAicsN3IAL1ZuPV7qyALcdCiawRJdEiafMxWTxzERQW7eeKg8HfCKCRK2CJicy073C4RJg/132, createdBy=464b2500186, createdName=ms1948154235210413, createdTime=Mon Jun 10 18:49:00 CST 2013, time=2013-06-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1817569, encodeId=05c2181e56919, content=<a href='/topic/show?id=4c9f9e777ac' target=_blank style='color:#2F92EE;'>#阿尔茨海#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97777, encryptionId=4c9f9e777ac, topicName=阿尔茨海)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Sat Dec 15 21:49:00 CST 2012, time=2012-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1469923, encodeId=78ca146992345, content=<a href='/topic/show?id=45a79e7788c' target=_blank style='color:#2F92EE;'>#阿尔茨海默#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97778, encryptionId=45a79e7788c, topicName=阿尔茨海默)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c5917090900, createdName=yhj-time, createdTime=Thu Sep 13 01:49:00 CST 2012, time=2012-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=4743, encodeId=6e884e43ae, content=原来如此,现在才了解了。谢谢这个专业网站, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=wumin, createdTime=Tue Sep 11 17:18:00 CST 2012, time=2012-09-11, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=1827460, encodeId=d748182e46071, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Thu Jul 25 01:49:00 CST 2013, time=2013-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1641252, encodeId=ecb3164125286, content=<a href='/topic/show?id=bb59966443f' target=_blank style='color:#2F92EE;'>#银杏叶#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96644, encryptionId=bb59966443f, topicName=银杏叶)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a91f22772330, createdName=12498bf3m32暂无昵称, createdTime=Wed Jan 23 00:49:00 CST 2013, time=2013-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1999216, encodeId=e64b199921643, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Wed Jan 23 06:49:00 CST 2013, time=2013-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1816546, encodeId=4013181654685, content=<a href='/topic/show?id=17b59e77626' target=_blank style='color:#2F92EE;'>#阿尔茨#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97776, encryptionId=17b59e77626, topicName=阿尔茨)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Bnia2EtH2IvyBtniaWHPQOYAicsN3IAL1ZuPV7qyALcdCiawRJdEiafMxWTxzERQW7eeKg8HfCKCRK2CJicy073C4RJg/132, createdBy=464b2500186, createdName=ms1948154235210413, createdTime=Mon Jun 10 18:49:00 CST 2013, time=2013-06-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1817569, encodeId=05c2181e56919, content=<a href='/topic/show?id=4c9f9e777ac' target=_blank style='color:#2F92EE;'>#阿尔茨海#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97777, encryptionId=4c9f9e777ac, topicName=阿尔茨海)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Sat Dec 15 21:49:00 CST 2012, time=2012-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1469923, encodeId=78ca146992345, content=<a href='/topic/show?id=45a79e7788c' target=_blank style='color:#2F92EE;'>#阿尔茨海默#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97778, encryptionId=45a79e7788c, topicName=阿尔茨海默)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c5917090900, createdName=yhj-time, createdTime=Thu Sep 13 01:49:00 CST 2012, time=2012-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=4743, encodeId=6e884e43ae, content=原来如此,现在才了解了。谢谢这个专业网站, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=wumin, createdTime=Tue Sep 11 17:18:00 CST 2012, time=2012-09-11, status=1, ipAttribution=)]
    2012-09-11 wumin

    原来如此,现在才了解了。谢谢这个专业网站

    0

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Neurology:一种廉价便利的AD血液检测法

一种廉价便利的阿尔茨海默病(Alzheimer's disease,AD)检测法在未来几年内即将出现,一份刊登在8月份的国际杂志Neurology上的研究报告中指出,研究者开发出了一种新型的AD血液检测法,新型方法可以在三组独立病人组中进行统计学分析。[Neurology 2012 Aug 1] 研究者William表示,重复最初结果的安全性和失败是这项领域最大的挑战,在这里我们阐述了这种一致性发

[AAIC 2012]阻力训练可改善老年女性的认知功能和功能可塑性

       在2012美国阿尔茨海默病协会国际会议上,来自加拿大和美国的研究人员向与会者介绍了阻力训练可改善老年女性的认知功能和功能可塑性。轻度认知障碍是实施痴呆干预的一个重要窗口。运动训练是一项有益的干预措施,但并非所有类型的训练也同样有效。因此,研究人员将可能患有轻度认知障碍的老年女性分为3组,分别进行阻力训练、有氧训练、平衡和声调训练,每周2次。该研

STM:大脑内Glymphatic系统有助治疗阿尔茨海默病

       最新发表于Science旗下医学刊物《转化医学》(Science Translational Medicine)杂志的一项研究表明,科学家发现了一个大脑快速清除废弃物的新渠道,这可能为阿尔茨海默病的治疗——清除β淀粉样蛋白铺平了道路。         研究发现的大脑新排污系统具有高度组织性

辉瑞放弃对阿尔茨海默病药物Bapineuzumab的研究

在得知又一项试验得出阴性结果之后,辉瑞公司决定停止对bapineuzumab的研究。 Bapineuzumab是一种旨在靶向作用于阿尔茨海默病患者脑部乙型淀粉样蛋白斑块的单克隆抗体药物。7月份辉瑞公司曾报告,一项对1,300例携带apo E4的阿尔茨海默病患者的Ⅲ期研究显示,bapineuzumab的药物效应为阴性。 与上述研究相同,这项纳入1,100例高危载脂蛋白E4等位基因(apo