The Relationship Between Polymorphism Of Apolipoprotein E Gene And Cognitive Impairment In Cerebrovascular Disease

Background:Vascular cognitive impairment (vascular cognitive impairement, VCI) is caused by vascular factors, different degrees of cognitive impairment, is a continuous disease spectrum, including the blood vessels causes a dangerous period from the brain to the various stages of mental retardation. As society ages, the incidence of cerebrovascular disease increased year by year, vascular cognitive impairment is increasingly attracted wide attention from scholars. Through the molecular level to study the relationship between ApoE and the VCI, VCI early recognition and to take effective measures to prevent and reverse the progress of cognitive impairment, there will be far-reaching social significance.Objective:APOE gene polymorphism of vascular cognitive impairment in the pathogenesis of the role played by the following four aspects to study, (1) study in patients with cerebral hemorrhage and cerebral infarction whether the differences in APOE genotype distribution; (2) a comparative analysis of the APOE gene in patients with cerebral infarction subtypes (ε2,ε3,ε4) between the different in degree of neurological impairment; (3) in the APOE gene in patients with cerebral infarction subtypes MMSE, MOCA scale score differences; (4) The APOE gene in patients with cerebral infarction subtypes of the differences between the P300.Methods:A case-control study on 300 cases of cerebrovascular disease (including 60 cases of cerebral hemorrhage and 240 cases of cerebral infarction) and 150 cases of the control group patients APOE gene polymorphism analysis to clear cerebral hemorrhage and cerebral infarction differences in the distribution of APOE genotype. APOE gene polymorphism and allele-specific multiplex polymerase chain reaction (ARMS-PCR) techniques were tested. Cognitive impairment use MMSE score and MOCA score. Neurological deficit with NIHSS score. As well as part of the evaluation of stroke patients to P300 testing of cognitive function.Results:1.ε3/3 genotype is the most common, accounting for 60% and 65.42%. Followed by theε2/3 andε3/4, the other three genotypesε2/2,ε2/4 andε4/4 genotype are rare genotype. ApoE3/4 genotype and s4 allele frequencies were significantly higher in ACI group compared with ICH. There was significant diffrient in statistics between the two groups (P <0.05). While theε2/3 genotype group the proportion of ICH more differences between the two groups was statistically significant, P<0.05. E2 frequency of cerebral hemorrhage was significantly higher than cerebral infarction group, while in the high frequency of cerebral infarctionε4 group, P<0.05. Difference was statistically significant. 2. Cerebral infarction in patients with different APOE genotypes (ε2,ε3,ε4) comparison between the degree of neurological impairment, APOE genotypesε4 higher degree of neurological impairment,and with a lower level of MMSE, and MOCA score than theε2,ε3.P <0.05, the difference was statistically significant. There was no statistically significant betweenε2 andε3.3. There are 50 cases of cerebral infarction were examed with P300 and EEG.There are 96% normal EEG and 4% mild abnormalities. The latency of P300 in APOE genotypesε4 carriers was prolonged significantly compared withε2,ε3, carriers. Theε2 carriers compared withε3,ε4 has a shorter period of latency,(P<0.05). The difference was statistically significant. EEG detected no difference among the three groups, P> 0.05.Conclusion:1. Theε4 are the risk factors to vascular cognitive impairment.While theε2 may play protective role in vascular cognitive impairment.2. In the cerebral infarction patients, the deficition of neurologics inε4 patients was serious than theε2,ε3.So theε4 is a risk factor for nerve damage. While the s2 was on the other hand toε4. Theε2 has a protective effect on the injury.In other words,ε2 have a fuction of nerve repairment.3. E4 in patients with cerebrovascular disease than carriers ofε2 carriers have a higher tendency to cerebral infarction. Whileε2 carriers suffering from a tendency to a higher cerebral hemorrhage.4. P300 of E4 carriers was significantly longer,so E4 may be the risk factor to VCI. The conclution is same withε4 is a major risk factorto AD.