Neurology:脑出血患者的 E型载脂蛋白质和脑血管疾病标志物 

2022-09-02 Naomi MedSci原创

近日,一项发表在Neurology上的研究证实了 APOE 等位基因和脑出血(ICH)之间的关联。研究分析显示了 APOEε2和 ε4等位基因与 FLP(CAA 的一个 CT 标记)之间的选择性关联。

近日,一项发表在Neurology上的研究探讨了 E型载脂蛋白质基因型(APOE)、脑出血(ICH)和脑淀粉样血管病(CAA)的神经影像学标志物之间的关系。

方法: 研究纳入了一项前瞻性多中心英国 ICH 患者观察队列研究和英国代表性人群对照的患者。首先,研究人员评估了 APOE 基因型与 ICH 的相关性(与没有 ICH 的对照组相比)。其次,在 ICH 患者中,还评估了 APOE 状态与血肿位置(肺叶或深部)和 CAA 的脑 X射线计算机断层成像(CT)标志物(指状突起[ FLP ]和蛛网膜下腔延伸[ SAE ])的关系。

结果:

  • 研究纳入了907例 ICH 患者和2636例对照组。
  • ICH 病例的平均年龄为73.2(12.4 SD)岁,而人群对照为69.6(0.2 SD)岁; 50.3% 的病例和42.1% 的对照是女性。
  • 与对照组相比,APOEε2等位基因在显性模型中与所有(脑叶和非脑叶)以及脑叶 ICH 自身相关,即任何 APOEε2等位基因(OR 1.38,95% CI 1.13-1.7,p = 0.002和 OR 1.50.95% CI 1.1.2.04,p = 0.01),但与对照相比,年龄调整分析(OR 1.26,95% CI 0.97-1.63,p = 0.08)。
  • 在仅病例分析中,与年龄调整分析中的深部 ICH 相比,APOEε4等位基因与脑叶相关(OR 1.56,95% CI 1.1-2.2,p = 0.01)。
  • 在评估 CAA 标志物时,APOE 等位基因与 FLP 独立相关(ε4: OR 1.74,95% CI 1.04-2.93,p = 0.04和 ε2/ε4:2.56,95% CI 0.99-6.61,p = 0.05)。
  • 研究没有发现 APOE 等位基因和 SAE 之间的关联。

研究证实了 APOE 等位基因和 ICH 之间的关联,包括脑叶 ICH。研究分析显示了 APOEε2和 ε4等位基因与 FLP (CAA 的一个 CT 标记)之间的选择性关联。研究结果表明,不同的 APOE 等位基因可能对 CAA 相关 ICH 的个体神经影像学生物标志物有不同的影响。

文献来源:Hostettler IC, Seiffge D, Wong A, et al. Apolipoprotein E and Cerebral Small Vessel Disease Markers in Patients With Intracerebral Haemorrhage [published online ahead of print, 2022 Jul 8]. Neurology. 2022;10.1212/WNL.0000000000200851. doi:10.1212/WNL.0000000000200851

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[GetPortalCommentsPageByObjectIdResponse(id=1799425, encodeId=96f51e99425b4, content=<a href='/topic/show?id=0ceee0685e7' target=_blank style='color:#2F92EE;'>#疾病标志物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70685, encryptionId=0ceee0685e7, topicName=疾病标志物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e68e415, createdName=juliusluan78, createdTime=Fri Nov 04 02:18:35 CST 2022, time=2022-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1841942, encodeId=c66418419422d, content=<a href='/topic/show?id=18bf61953d3' target=_blank style='color:#2F92EE;'>#标志物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61953, encryptionId=18bf61953d3, topicName=标志物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6ab940, createdName=hukaixun, createdTime=Wed Jun 14 18:18:35 CST 2023, time=2023-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1799422, encodeId=f79f1e994223c, content=<a href='/topic/show?id=b814e0684aa' target=_blank style='color:#2F92EE;'>#疾病标志#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70684, encryptionId=b814e0684aa, topicName=疾病标志)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0ee7414, createdName=lanyan20020086, createdTime=Wed Dec 21 09:18:35 CST 2022, time=2022-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2001931, encodeId=3bed20019311f, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, 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objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88701, encryptionId=158288e017c, topicName=蛋白质)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Thu Sep 01 12:18:35 CST 2022, time=2022-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1361314, encodeId=148a136131407, content=<a href='/topic/show?id=2c509364ea9' target=_blank style='color:#2F92EE;'>#载脂蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93647, encryptionId=2c509364ea9, topicName=载脂蛋白)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f1167, createdName=wmr111, createdTime=Thu Sep 01 12:18:35 CST 2022, time=2022-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1424848, encodeId=6fda1424848a1, content=<a href='/topic/show?id=5a3b8441438' target=_blank style='color:#2F92EE;'>#脂蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84414, encryptionId=5a3b8441438, topicName=脂蛋白)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=23ea3924919, createdName=juliusluan79, createdTime=Thu Sep 01 12:18:35 CST 2022, time=2022-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1428808, encodeId=929f1428808ec, content=<a href='/topic/show?id=c9ae85106df' target=_blank style='color:#2F92EE;'>#脑血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85106, encryptionId=c9ae85106df, topicName=脑血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=13c94134529, createdName=lfyang, createdTime=Thu Sep 01 12:18:35 CST 2022, time=2022-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1499114, encodeId=f30c1499114c5, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Thu Sep 01 12:18:35 CST 2022, time=2022-09-01, status=1, ipAttribution=)]
    2023-03-29 yinhl1978
  5. 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time=2022-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1499114, encodeId=f30c1499114c5, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Thu Sep 01 12:18:35 CST 2022, time=2022-09-01, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1799425, encodeId=96f51e99425b4, content=<a href='/topic/show?id=0ceee0685e7' target=_blank style='color:#2F92EE;'>#疾病标志物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70685, encryptionId=0ceee0685e7, topicName=疾病标志物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e68e415, createdName=juliusluan78, createdTime=Fri Nov 04 02:18:35 CST 2022, time=2022-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1841942, encodeId=c66418419422d, content=<a href='/topic/show?id=18bf61953d3' target=_blank style='color:#2F92EE;'>#标志物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61953, encryptionId=18bf61953d3, topicName=标志物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6ab940, 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  7. [GetPortalCommentsPageByObjectIdResponse(id=1799425, encodeId=96f51e99425b4, content=<a href='/topic/show?id=0ceee0685e7' target=_blank style='color:#2F92EE;'>#疾病标志物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70685, encryptionId=0ceee0685e7, topicName=疾病标志物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e68e415, createdName=juliusluan78, createdTime=Fri Nov 04 02:18:35 CST 2022, time=2022-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1841942, encodeId=c66418419422d, content=<a href='/topic/show?id=18bf61953d3' target=_blank style='color:#2F92EE;'>#标志物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61953, encryptionId=18bf61953d3, topicName=标志物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6ab940, 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JAHA:脑出血后神经功能恶化的预测评分

该研究开发得到的SIGNALS评分可靠地预测了脑出血患者住院神经系统恶化的风险。

Pharmacol Res:中医药在脑出血病理生理过程中的应用

脑出血(Intracebral hemorrhage,ICH)是第二常见的卒中亚型,具有高发病率、残疾和死亡率。

拓展阅读

【综述】血清β2微球蛋白与脑小血管病相关性研究进展

本文结合国内外最新研究对血清β2M与常见CSVD病因分型(小动脉硬化型和脑淀粉样蛋白变性型)以及不同的CSVD影像学表现的相关性进行综述。

【综述】光学相干断层扫描血管成像技术在脑小血管病中的应用研究进展

本文就OCTA在CSVD中的应用进行综述,以期为CSVD的早期识别和动态评估提供帮助。

【综述】三酰甘油葡萄糖指数与脑小血管病相关性的研究进展

本文结合国内外TyG指数与CSVD关系的研究进行综述,以期为CSVD高危人群的早期识别和干预提供新思路。

【论著】基于7. 0 T磁共振成像及体素形态学测量对脑小血管病灰质体积变化及其与认知障碍的相关性研究

本研究应用7. 0T MRI及VBM技术,探索CSVD认知障碍患者灰质体积改变脑区及与其相关的受损认知域。

ART:浙大研究提示脑类淋巴在脑小血管病和阿尔茨海默病中的作用

AD 病理(Aβ)和 CSVD 均与脑类淋巴功能障碍有关,而类淋巴功能障碍又与认知障碍进一步相关。

Neurology:CADMUS——基于MRI的自发性脑出血与脑小血管疾病相关的新型分类方法

CADMUS 是一种基于 MRI 的 SVD 相关 ICH 新型分类方法,具有可行性和可重复性

《脑出血医疗质量控制指标》的解读

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2023 ESO 专家共识声明:脑出血患者应使用急性集束化护理

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2023 重症成人脑出血患者的神经预测指南

国外神经内科相关专家小组(统称) · 2023-11-03

《中国脑出血诊治指南2019》更新要点及解读

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