目的探讨载脂蛋白(Apo)E基因型与伴有高甘油三酯血症的复发性急性胰腺炎的关系。方法将患者入院后空腹血清甘油三酯(TG)水平≥2.3mmol/L作为高甘油三酯血症的入选标准,采用聚合酶链反应检测115例伴有高甘油三酯血症的复发性急性胰腺炎患者的ApoE基因型。并根据空腹血清TG水平分为TG轻度升高组:2.3mmol/L≤TG〈5.5mmol/L;TG中度升高组:5.5mmol/L≤TG〈11.3mmol/L;TG极度升高组:TG≥11.3mmol/L。结果TG极度升高组中因胆道疾病、饮食不当和酒精性因素而复发的患者比例显著低于TG轻度升高组和TG中度升高组(P〈0.05);而既往具有中度以上高甘油三酯血症史(≥5.5mmol/L)的患者占75%,显著高于另两组(P〈0.01)。TG极度升高组的E3/4、E3/2、E2/4、E2/2基因型患者比例显著高于另两组(P〈0.05)。TG中度升高组的E3/2基因型患者比例显著高于TG轻度升高组(P〈0.05)。TG极度升高组的等位基因ε2、ε4的频率显著高于另两组(P〈0.05)。TG中度升高组的等位基因ε2的频率高于TG轻度升高组(P〈0.05)。结论Apoe2和ε4等位基因可能与伴有中度以上高甘油三酯血症的复发性急性胰腺炎有关。
Objective To explore the relationship of apolipoprotein E (ApoE) genotype with hypertriglyceridemia-associated recurrent acute pancreatitis. Methods Taking the fasting serum triglyceride (TG) level ≥ 2.3 mmol/L as hypertriglyceridemia, ApoE genotypes in 115 patients with hypertriglyceridemia-associated recurrent acute pancreatitis were assessed by polymerase chain reaction. According to the fasting serum TG level, all patients were divided into 3 groups: TG mild elevation group (2. 3 mmol/L ≤TG 〈 5.5 mmol/L, Group A ) , TG moderate elevation group ( 5.5 mmol/L ≤TG 〈 11.3 mmol/L, Group B) , and TG severe elevation group (TG ≥ 11.3 mmol/L, Group C). Results Group C had significantly fewer patients with biliary tract disease, improper diet and heavy alcohol consumption, and significantly more patients with passed history of moderate-severe hypertriglyceridemia than Group A and B (P 〈0. 05). The proportion of patients with E3/4, E3/2,E2/4 and E2/2 genotypes and gene frequency for s2 and ε4 alleles are significantly higher in Group C than in Group A and B ( P 〈 0. 05 ). Group B had significantly more patients with E3/2 genotype and higher gene frequency for ε2 allele than Group A ( P 〈 0. 05 ). Conclusions Apo ε2 and ε4 alleles are closely related to moderate-severe hypertriglyceridemia-associated recurrent acute pancreatitis.