目的：分析武汉地区大动脉粥样硬化型（LAA）缺血性脑卒中患者载脂蛋白E（ApoE）基因多态性的分 布。方法：选取武汉大学人民医院神经内科治疗的LAA型缺血性脑卒中患者179例和健康对照者104例为 研究对象。采用聚合酶链反应（PCR）-荧光探针技术检测卒中组和对照组外周血样本，统计并分析基因型和 等位基因频率的差异，分别比较 2 组不同等位基因组的总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白 （HDL）、低密度脂蛋白（LDL）水平。结果：2组均以ε3/ε3基因型频率最多。对照组ε3/ε3基因频率高于卒中 组（P＜0.05），卒中组ε3/ε4 和ε4/ε4 分布高于对照组（P＜0.05）；卒中组ε4 等位基因频率高于对照组（P＜ 0.05），ε3 等位基因频率低于对照组（P＜0.05）。性别对于 ApoE 基因型的分布差异无统计学意义（P＞ 0.05）。对照组ε4型TC、TG、LDL水平均高于ε2型和ε3型（P<0.05或P<0.01）；卒中组ε4型TC水平显著高于ε 2型和ε3型，LDL水平显著高于ε2型（均P＜0.01）。结论：武汉地区LAA型缺血性脑卒中患者ApoE的基因 多态性分布与性别无关但影响血脂水平，ε4可能为LAA型缺血性脑卒中的易感因子和危险因素之一。

To analyze the polymorphism distribution of the Apolipoprotein E (ApoE) gene in large artery atherosclerosis (LAA)-subtype ischemic stroke (IS) patients in Wuhan. Methods: One-hundred and seventy-nine patients of LAA-subtype IS and 104 healthy controls were selected from the Department of Neurology, Renmin Hospital of Wuhan University. The polymerase chain reaction (PCR)-fluorescence probe technique was used to detect peripheral blood samples from the stroke group and the control group. The differences in the ApoE genotypes and the allele frequency were statistically analyzed. The levels of total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL), and 1ow density lipoprotein cholesterol (LDL) in the different allele sub-groups were compared between the two groups. Results: The frequency of the ε 3/ε 3 genotype was the highest in both the stroke group and the control group. The ε 3/ε 3 genotype frequency of the control group was higher than that of the stroke group (P<0.05). The distribution of ε3/ ε4 and ε4/ε4 genotypes in the stroke group was higher than that in the control group (P<0.05). Compared with the control group, the frequency of ε4 allele was significantly increased and that of the ε3 allele was significantly decreased in the stroke group (P<0.05). There was no significant difference in the distribution of ApoE genotypes among stroke patients with different genders (P>0.05). In the control group, the levels of TC, TG, and LDL of the ε4 phenotype were higher than those of the ε2 and ε3 phenotypes (P<0.05 or P<0.01). In the stroke group, the level of TC in ε4 phenotype was significantly higher than that in the ε2 and ε3 phenotypes (P<0.01), and the level of LDL in the ε4 phenotype was significantly higher than that in the ε2 phenotype (P<0.01). Conclusion: The polymorphic distribution of ApoE in the LAA-subtype IS in the Wuhan area is independent with sex but does affect the levels of blood lipid; ε 4 may be one of the susceptibility factors and risk factors for the LAA-subtype IS