ApoE-杞借剛铔嬬櫧E娴嬪畾璇曞墏鐩?鍏嶇柅姣旀祳娉?
--鍙嶆槧鑴傝泲鐧戒唬璋㈡柊鎸囨爣锛岄珮鑴傝鐥囩殑杈呭姪璇婃柇鎸囨爣
鏍锋湰绫诲瀷锛氳娓匋/p>
閫傜敤浠櫒锛氭湰璇曞墏鐩掗€傜敤浜庣粷澶у鏁颁富娴佺敓鍖栧垎鏋愪华
璇曞墏鐩掍紭鍔军/h4>
1.鑾疯瘯鍓傜洅涓撳埄
2.閲囩敤鍏嶇柅姣旀祳娉曪紝鎻愰珮鐏垫晱搴﹀拰鐗瑰紓鎬?/p>
3.绾挎€ц寖鍥村锛?.0锝?2.0 mg/dL
鎸囨爣绠€浠婞/h3>
杞借剛铔嬬櫧E锛圓polipoprotein E锛孉poE锛夋槸涓€绉嶅瘜鍚簿姘ㄩ吀鐨勭硸鍩哄寲銆佺⒈鎬с€佸垎娉岃泲鐧斤紱鐢?99涓皑鍩洪吀娈嬪熀缁勬垚锛涚浉瀵瑰垎瀛愯川閲忕害涓?4kD锛屼富瑕佸湪鑲濊剰鍚堟垚銆佸垎娉屽拰浠ｈ阿銆侫poE鐢熺悊鍔熻兘鏈夛細鈶犳槸浣庡瘑搴﹁剛铔嬬櫧锛圠DL锛夌殑閰嶄綋锛屼篃鏄倽缁嗚優涔崇硿寰矑锛圕M锛夋畫绮掑彈浣撶殑閰嶄綋锛屼笌鑴傝泲鐧戒唬璋㈡湁瀵嗗垏鐩稿叧鎬э紱鈶poE鍏锋湁澶氭€佹€э紝澶氭€佹€т笌鍐冲畾涓綋琛€鑴傛按骞充笌鍔ㄨ剦绮ユ牱纭寲鍙戠敓鍙戝睍瀵嗗垏鐩稿叧锛涒憿鍙備笌婵€娲绘按瑙ｈ剛鑲殑閰剁被锛屽弬涓庡厤鐤皟鑺傚強绁炵粡缁勭粐鐨勫啀鐢熴€侟/p>
妫€娴嬪師鐞咟/h3>
鏍锋湰涓瑼poE涓庤瘯鍓備腑鐨勭壒寮傛€ф姉浜篈poE鎶椾綋鐩哥粨鍚堬紝褰㈡垚涓嶆憾鎬у厤鐤鍚堢墿锛屼娇鍙嶅簲娑蹭骇鐢熸祳搴︼紝鍦ㄦ尝闀?40nm娴嬪畾鍚稿厜搴︼紝娴婂害楂樹綆鍙嶆槧鏍锋湰涓瑼poE鐨勫惈閲忋€侟/p>
涓村簥搴旂敤
- ApoE涓庨珮鑴傝鐥囷細楂樿剛琛€鐥?鍗宠鑴傚紓甯?鏄寚琛€鑴傛按骞宠繃楂橈紝鍙洿鎺ュ紩璧蜂竴浜涗弗閲嶅嵄瀹冲仴搴风殑鐤剧梾锛屽鍔ㄨ剦绮ユ牱纭寲銆佸啝蹇冪梾銆佽儼鑵虹値绛夈€傝娓匒po E鍗囬珮瀵归珮鑴傝鐥囨湁鐩稿綋璇婃柇鎰忎箟锛屼笖ApoE甯镐笌TG鍛堟瘮渚嬪叧绯汇€侫po E/ApoB姣旂巼涓衡參鍨嬮珮鑴傝鐥?TG↑↑, TC↑↑)鐨勮瘖鏂寚鏍囥€侟/li>
- ApoE娴嬪畾鍙綔涓哄績琛€绠＄柧鐥呯殑杈呭姪璇婃柇锛欰poE鏄啝蹇冪梾鍜屽姩鑴夌播鏍风‖鍖栫殑鍗遍櫓鍥犲瓙銆傚啝蹇冪梾鎮ｈ€呭父瑙佽娓匒poE鍗囬珮銆傛潵鑷ぇ鍨嬭崯钀冨垎鏋愮殑璇佹嵁琛ㄦ槑锛孉poE涓庡啝蹇冪梾(CHD)鍛堟鍚戝墏閲忓弽搴旂浉鍏筹紝涓庤瀵熷埌鐨凩DL-C缁撴灉涓€鑷淬€侟/li>
- ApoE鏄剳姊楀鐨勯噸瑕佽瘖鏂寚鏍囷細鑴戞濉炵殑鍙戠梾涓昏鍜岄鍔ㄨ剦绮ユ牱纭寲鏈夊叧锛岄珮琛€鍘嬪拰楂樿鑴傛槸寮曞彂鑴戞濉炵殑鐙珛鍗遍櫓鍥犵礌銆傝娓匒poE涓庤剳姊楀鍏崇郴瀵嗗垏锛屾槸鍏堕噸瑕侀闄╁洜瀛愩€傜爺绌惰〃鏄嶞span style="color:hsl(212,80%,42%);">[4]锛屽綋ApoE銆乀C鍜孡DL-C涓夐」妫€鏌ュ悓鏃跺崌楂樻椂瀵硅剳姊楀璇婃柇鐨勭壒寮傛€с€侀槼鎬ч娴嬪€煎潎鍙揪100%锛屽彲浣滀负鑴戞濉炵殑閲嶈璇婃柇鎸囨爣涔嬩竴銆侟/li>
- ApoE涓庣粏鑿屾劅鏌撴€х柧鐥咃細ApoE闄ゅ弬涓庤剛璐ㄨ繍杈撲笌浠ｈ阿澶栵紝鍦ㄥ厤鐤皟鑺傚拰鐐庢€у弽搴旀柟闈篃鏈変竴瀹氫綔鐢ㄣ€侫poE浣滀负LDL-R鐨勯厤浣擄紝鑳藉寮哄澶氱寰敓鐗╂劅鏌撴墍鑷寸殑鏈轰綋鍏嶇柅鍙嶅簲锛屽鎻愰珮鑷劧鏉€浼ょ粏鑳?NK缁嗚優)鏁伴噺銆佷績杩汵K缁嗚優澧炴畺杩愯緭锛屽苟褰卞搷鍏跺悗缁殑鍏嶇柅鍙嶅簲[5]銆傛湁鐮旂┒鍙戠幇锛屼笌鍏朵粬鎰熸煋鍜屾湭鎰熸煋鍎跨鐩告瘮锛岃触琛€鐥囨垨缁嗚弻鎬ц剳鑶滅値鎮ｈ€呯殑琛€娓匒poE鏄捐憲鍗囬珮銆傝娓呯殑鏈€浣矨poE涓寸晫鍊?gt;42mg/L锛岀伒鏁忓害鍜岀壒寮傛€у悇涓?0%鍜?3%;ApoE妫€娴嬫槸璇婃柇鍎跨缁嗚弻鎰熸煋鐨勬柊鎸囨爣[6]銆傛湵鏈堟竻绛堻span style="color:hsl(212,80%,42%);">[7]鐮旂┒鍙戠幇锛孉poE鏄弽鏄犲尰闄㈣幏寰楁€ц偤鐐?HAP)鐨勬綔鍦ㄦ寚鏍囷紝鍙垽鏂劅鏌撶殑涓ラ噸绋嬪害鍙婃偅鑰呴鍚庛€侟/li>
- ApoE涓庤偩鑴忕柧鐥咃細杩戝勾鏉ョ爺绌跺彂鐜帮紝ApoE鍦ㄥ绉嶈偩鑴忕柧鐥呯殑鍙戠敓鍙戝睍涓彂鎸ラ噸瑕佷綔鐢ㄣ€傜爺绌跺彂鐜帮紝鎵€鏈夎剛铔嬬櫧鑲惧皬鐞冪梾鎮ｈ€呰娓呬腑ApoE姘村钩鍧囧湪鍋ュ悍浜虹殑2鍊嶄互涓婏紝鍗充娇鏃犻珮琛€鑴傜棁鏃朵篃鏄庢樉澧為珮锛屽洜姝よ剛铔嬬櫧鑲惧皬鐞冪梾涓嶢poE姘村钩寮傚父鍜屽彉寮傛湁鍏颤span style="color:hsl(212,80%,42%);">[8]銆傚惔鏅▼绛堻span style="color:hsl(212,80%,42%);">[9]鐮旂┒鍙戠幇锛岀硸灏跨梾鑲剧梾鎮ｈ€呰娓匒poE姘村钩鏄捐憲楂樹簬鏃犵硸灏跨梾鑲剧梾鑰咃紝楂楢poE缁勫翱鐧借泲鐧?鑲岄厫姣斿€?ACR)鏄庢樉楂樹簬浣嶢poE缁勶紝ApoE鏄翱鐧借泲鐧?鑲岄厫姣斿€肩殑鐙珛褰卞搷鍥犵礌銆侟/li>
- ApoE涓庤倽鐥咃細ApoE涓昏鐢辫倽鑴忓悎鎴愬拰浠ｈ阿锛屽洜姝や笌鑲濈梾鍏崇郴瀵嗗垏銆傚綋鑲濊剰鍚堟垚铔嬬櫧(鍖呮嫭apoE)鍔熻兘闅滅鏃讹紝琛€娓卆poE姘村钩涓嬮檷;鑰屽綋鑲濊剰娓呴櫎鍚玜poE鐨勮剛铔嬬櫧鍔熻兘闅滅鏃讹紝琛€娓卆poE姘村钩鍗囬珮[10]銆傚垬绾㈡槬绛堻span style="color:hsl(212,80%,42%);">[11]鐮旂┒鍙戠幇锛屾€ユ€ц倽鐐庢€ユ€ф湡銆佹參鎬ц倽鐐庛€佽倽纭寲銆佽剛鑲倽銆佽倽鐧岀瓑鐤剧梾閮藉彲瀵艰嚧琛€娓匒poE姘村钩涓婂崌锛岃剛鑲倽涓庢甯稿鐓ф棤宸紓銆傛€ユ€ц倽鐐庢€ユ€ф湡ApoE娴撳害楂樹簬鎭㈠鏈燂紝鑰岄粍鐤稿瀷鍙堥珮浜庢棤榛勭柛鍨嬨€傛€ユ€ч粍鐤稿瀷鑲濈値鎬ユ€ф湡apoE娴撳害鏄捐憲楂樹簬鎭㈠鏈熴€傝娓匒poE娴撳害娴嬪畾瀵瑰弽鏄犺倽缁嗚優鍔熻兘鍙婃筏鑳嗙▼搴︽湁涓€瀹氫环鍊笺€侟/li>
- ApoE涓庣郴缁熸€х孩鏂戠嫾鐤細鐮旂┒琛ㄦ槑锛孉poE鍙備笌澶氱鑷韩鍏嶇柅鎬х柧鐥呯殑鍙戠敓銆佸彂灞曡繃绋嬨€傚畨鍜屽叺绛堻span style="color:hsl(212,80%,42%);">[12]鐮旂┒鍙戠幇锛岀郴缁熸€х孩鏂戠嫾鐤?SLE)鎮ｈ€呯粍 ApoE鎬讳綋琛ㄨ揪姘村钩鍗囬珮锛屽叾涓細娲诲姩缁凙poE杈冮潪娲诲姩缁勫崌楂樻洿涓烘槑鏄禁鐙肩柈鎬ц偩鐐庣粍鍜岄潪鐙肩柈鎬ц偩鐐庣粍琛€娓匒poE姘村钩杈冨仴搴峰鐓х粍鍗囬珮锛屼絾涓ょ粍闂村樊寮傛棤缁熻瀛︽剰涔堺鎶楀弻閾綝NA(ds-DNA)鎶椾綋闃虫€х粍鎮ｈ€呰娓匒poE姘村钩杈冩姉ds-DNA鎶椾綋闃存€х粍鏄庢樉鍗囬珮銆侫poE鍙綔涓哄弽鏄燬LE鎮ｈ€呯梾鎯呮椿鍔ㄧ殑鏈夋晥鎸囨爣锛屼负鐤剧梾鍏嶇柅娌荤枟鎻愪緵鐞嗚渚濇嵁銆侟/li>
- ApoE涓庣檶鐥囷細ApoE浣滀负涓€绉嶄笌缁嗚優澧炴畺鐩稿叧铔嬬櫧锛岃兘鎶戝埗鑲跨槫鍧忔鍥犲瓙TNF-α娲绘€э紝浠庤€屽彲鑳藉弬涓庤偪鐦ゅ彂灞曞強杞Щ銆侫poE鍦ㄥ嵉宸㈢檶銆侀潪灏忕粏鑳炶偤鐧屻€佸墠鍒楄吅鐧屻€佸瓙瀹唴鑶滅檶銆佺粨鑲犵檶銆佽儍鐧屻€佽儼鑵虹檶涓〃杈惧楂楛span style="color:hsl(212,80%,42%);">[13]銆侫poE涓庡嵉宸㈢檶鍏崇郴鐩墠杈冧负鏄庣‘锛孉poE鐨勯珮琛ㄨ揪涓哄嵉宸㈢檶鐨勬槗鎮ｅ洜绱犮€侫poE琛ㄨ揪涓婅皟鏄墠鍒楄吅鐧岀殑鍗遍櫓鍥犵礌涔嬩竴銆侫poE涓庡瓙瀹唴鑶滅檶鎭舵€х▼搴︽鐩稿叧銆侟/li>
閫傜敤绉戝
|
閫傜敤绉戝 |
閫傛浜虹兢 |
|
鍐呯/蹇冨唴绉慄/strong> |
鑲ヨ儢浜虹兢銆侀珮鑴傝鐥囥€佸啝蹇冪梾銆佺硸灏跨梾銆?/p> |
|
绁炵粡鍐?绁炵粡澶栫 |
鑴戞濉炪€佷腑椋庛€佺棿鍛咟/p> |
|
鎰熸煋绉?ICU/鎬ヨ瘖绉慄/strong> |
璐ヨ鐥囥€佺粏鑿屾€ц剳鑶滅値銆佸尰闄㈣幏寰楁€ц偤鐐?HAP)銆佽創姣掔棁銆佽倽鐐嶞/p> |
|
鑲惧唴绉慄/strong> |
鑴傝泲鐧借偩灏忕悆鐥呫€佺硸灏跨梾鑲剧梾 |
|
鑲濊儐绉?娑堝寲鍐呯 |
鑲濈‖鍖栥€佽倽鐧屻€佽剛鑲倽 |
|
椋庢箍鍏嶇柅绉慄/strong> |
绯荤粺鎬х孩鏂戠嫾鐤?/p> |
|
鑲跨槫绉慄/strong> |
鍗靛发鐧屻€侀潪灏忕粏鑳炶偤鐧屻€佸墠鍒楄吅鐧屻€佸瓙瀹唴鑶滅檶銆佺粨鑲犵檶銆佽儍鐧屻€佽儼鑵虹檶绛堻/p> |
鍙傝€冩枃鐚?/h3>
[1] Khan TA., et al.,Apolipoprotein E genotype, cardiovascular biomarkers and risk of stroke: systematic review and meta-analysis of 14,015 stroke cases and pooled analysis of primary biomarker data from up to 60,883 individuals. Int J Epidemiol. 2013 Apr;42(2):475-92.
[2] 绔ユ槑瀹?闄惰崳闇?鏉庣泩,绛? 杞借剛铔嬬櫧E鍙婅剛铔嬬櫧(a)涓庡啝蹇冪梾鐨勭浉鍏虫€у垎鏋怺J]. 妫€楠屽尰瀛?2017,32(6):490-494.
[3] 璧靛叞闈?闊╂尟鏍?鍒樻槬鍏?绛? 杞借剛铔嬬櫧E鍦ㄥ績琛€绠＄柧鐥呬腑鐨勮瘖鏂环鍊糩J]. 鍥介檯妫€楠屽尰瀛︽潅蹇?2014(6):733-734,737.
[4] 闄堜紵,杈滄窇鑻? 琛€娓卆poE鍜岃鑴傛按骞虫娴嬪鑴戞姝荤殑璇婃柇浠峰€糩J]. 绗洓鍐涘尰澶у瀛︽姤,2001,22(23):2201-2203.
[5] 鏉庣閿? 琛€娓呰浇鑴傝泲鐧紼瀹氶噺妫€娴嬪強涓村簥搴旂敤[J]. 涓崕涓村簥瀹為獙瀹ょ鐞嗙數瀛愭潅蹇?2017,5(3):146-148.
[6] Wang C, Wang Y, Wang A, Fu P, Yang Y. The diagnostic value of apolipoprotein E in pediatric patients with invasive bacterial infections. Clin Biochem. 2012 Feb;45(3):215-8.
[7] 鏈辨湀娓?鏈卞皬鏋?鏈辩鑺? 琛€娓呰浇鑴傝泲鐧紼妫€娴嬪湪鍖婚櫌鑾峰緱鎬ц偤鐐庤瘖鏂拰棰勫悗涓殑浠峰€糩J]. 涓浗鍗敓妫€楠屾潅蹇?2015,25(9):1382-1383,1386.
[8]Saito T, Matsunaga A, Oikawa S. Impact of lipoprotein glomerulopathy on the relationship between lipids and renal diseases. Am J Kidney Dis. 2006 Feb;47(2):199-211.
[9] 鍚存櫙绋?鏉庢檽鍗?褰案寰? 2鍨嬬硸灏跨梾鎮ｈ€呰浇鑴傝泲鐧紼姘村钩涓庣硸灏跨梾鑲剧梾鐨勫叧绯荤爺绌禰J]. 涓崕鍐呭垎娉屼唬璋㈡潅蹇?2013,29(10):879-881.
[10] 鍒樼孩鏄?澶忓痉鍏? 杞借剛铔嬬櫧E鐨勭敓鐗╁鐗规€у強涓村簥鎰忎箟[J]. 鍥藉鍖诲(鍐呯瀛﹀垎鍐?,1997, (6):248-250,276.
[11] 鍒樼孩鏄?澶忓痉鍏?鍛ㄥ悍,绛? 鑲濈梾鎮ｈ€呰娓呰浇鑴傝泲鐧紼娴撳害娴嬪畾鐨勪复搴婃剰涔塠J]. 涓婃捣鍖荤澶у瀛︽姤,1997, (6):429-431.
[12] 瀹夊拰鍏?杈规睙,璐炬収瀹? 杞借剛铔嬬櫧E鍦ㄧ郴缁熸€х孩鏂戠嫾鐤偅鑰呬腑鐨勮〃杈惧強鍏朵复搴婃剰涔塠J]. 妫€楠屽尰瀛︿笌涓村簥,2014(10):1356-1357.
[13] 閮洓铏?鍙插仴. 杞借剛铔嬬櫧E鍦ㄨ鏍撶浉鍏虫€х柧鐥呭強鎭舵€ц偪鐦や腑鐨勭爺绌惰繘灞昜J]. 涓浗鍏ㄧ鍖诲,2013,16(5):590-592.
鎸囧崡鍏辫瘑
