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目的:分析载脂蛋白E(n ApoE)基因多态性对缺血性脑梗死患者他汀类降脂药物疗效的影响。n 方法:选取缺血性脑梗死患者106例，连续给予他汀类降脂药物3个月，分析服药前后血清三酰甘油(triglyceride，TG)、胆固醇(total cholesterol，TC)、高密度脂蛋白固醇(high-density liptein cholesterol，HDL-C)、低密度脂蛋白胆固醇(low-density liptein cholesterol，LDL-C)的变化，用实时荧光定量PCR测定其n ApoE基因的多态性，比较不同疗效患者的基因型分布。n 结果:在106例患者中，E2/E2、E2/E3、E3/E3、E2/E4、E3/E4基因型的检出率分别为0.94%、11.32%、63.21%、1.89%、22.64%；E2、E3、E4等位基因的检出率分别为7.55%、80.19%、12.26%。患者按生化表型分为E2型13例(12.26%)、E3型69例(65.09%)、E4型24例(22.65%)。服药前E2型TG、TC最高(n P0.05)，服药后TG、TC、LDL-C均下降，而HDL-C水平升高，且E2型的HDL-C最高，E4型的TC、LDL-C最高(n P<0.05)；低效组入院时n ApoE分型中E3/E3的比例低于高效组，E3/E4的比例高于高效组(n P<0.05)，低效组E3等位基因的比例低于高效组，E4等位基因的比例高于高效组(n P<0.05)。n 结论:ApoE基因多态性与缺血性脑梗死患者的他汀类药物降脂效果有密切关系，其中E2、E3基因携带者血脂下调效果显著，E4基因携带者降脂效果差，应采取个体化给药方案。n “,”Objective:To assess the influence of apolipoprotein E (n ApoE) gene polymorphisms on the therapeutic effect of lipid-lowering statins in patients with ischemic cerebral infarction.n Methods:One hundred and six patients with ischemic cerebral infarction who orally took lipid-lowering statins for 3 months were enrolled. Changes in serum triacylglycerol (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) before and after the drug administration were analyzed. n ApoE gene polymorphisms were detected by real-time fluorescent quantitative PCR, and genotypes of n ApoE gene in patients with different effects were compared.n Results:The detection rates for E2/E2, E2/E3, E3/E3, E2/E4 and E3/E4 genotypes were 0.94%, 11.32%, 63.21%, 1.89% and 22.64%, respectively. And the detection rates for E2, E3 and E4 alleles were 7.55%, 80.19% and 12.26%, respectively. Biochemical phenotypes included E2 type (13 cases, 12.26%), E3 type (69 cases, 65.09%) and E4 type (24 cases, 22.65%). Before administration, TG and TC of E2 type were the highest (n P0.05). Following the drug administration, TG, TC and LDL-C were decreased, while HDL-C was increased. HDL-C of E2 type was the highest, TC and LDL-C of E4 type were the highest(n P<0.05). The E3/E3 ratio in low-efficiency group at admission was lower than that in the high-efficiency group, while the E3/E4 ratio was higher than that in the high-efficiency group (n P<0.05). The proportion of E3 allele in low-efficiency group was lower than that in high-efficiency group, while the proportion of E4 allele was higher than that in high-efficiency group (n P<0.05).n Conclusion:ApoE gene polymorphisms are closely correlated with the therapeutic effect of lipid-lowering statins in patients with ischemic cerebral infarction. The lipid-lowering effects are more significant in patients with E2 and E3 genotypes, but were poor in those with the E4 genotype. Personalized regimens should be applied.n