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目的探讨颅脑创伤是否在载脂蛋白E基因(apolipoprotein E,APOE)对脑电活动的影响当中起诱发作用。方法收集118例轻-中型创伤性脑损伤患者的临床资料和40例正常成人的相关信息,采用聚合酶链反应限制性片段长度多态性法(PCR-RFLP)检测APOE基因型。在伤后1～3 d,对所有创伤性脑损伤患者进行脑电图检测;在清醒、安静、闭目、血糖正常状态下对所有正常成人进行脑电图检测;采集所有研究对象的定量脑电数据。结果40例正常成人中,APOEε2、APOEε3、APOEε4基因型之间定量数据差异均无统计学意义(P=0.097);118例创伤性脑损伤患者中,脑电活动在APOEε2、APOEε3、APOEε4基因型之间差异有统计学意义(P=0.008);与APOEε3携带者比较,APOEε4携带者的慢活动明显增多,而APOEε2携带者的慢活动相对减少。结论携带不同APOE基因的正常成人脑电活动无差异;在颅脑创伤的诱发下,APOE对脑电活动的影响则表现出亚型特异性;APOEε4对颅脑创伤后的脑电活动带来负面影响,APOEε2则对创伤后的脑功能具有保护作用。
Objective To investigate whether traumatic brain injury plays an inducing role in the influence of apolipoprotein E (APOE) on electroencephalogram activity. Methods The clinical data of 118 patients with mild to moderate traumatic brain injury and the information of 40 normal adults were collected. The APOE genotypes were detected by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP). EEG was performed on all traumatic brain injury patients 1 ~ 3 days after injury; EEG was performed on all normal adults under awake, quiet, closed eyes and normal blood glucose condition; quantitative brain Electrical data. Results There was no significant difference in the quantitative data of APOEε2, APOEε3 and APOEε4 among 40 normal adults (P = 0.097). Among the 118 traumatic brain injury patients, the electroencephalogram activity of APOEε2, APOEε3 and APOEε4 genotypes was not significantly different (P = 0.008). Compared with APOEε3 carriers, the slow activity of APOEε4 carriers was significantly increased, while the slow activity of APOEε2 carriers was relatively decreased. CONCLUSION: There is no difference in EEG activity among normal adult patients carrying different APOE genes. The effect of APOE on EEG activity is subtype-specific when induced by traumatic brain injury. APOEε4 negatively affects EEG activity after traumatic brain injury APOEε2 has a protective effect on post-traumatic brain function.