目的：探讨水通道蛋白4（AQP4）基因多态性与高血压脑出血（HICH）患者迟发性脑水肿的关系。方 法：137例HICH患者按照是否合并迟发性脑水肿分为病例组42例和对照组95例，采用聚合酶链反应-直接 测序分型法检测 AQP4基因 rs1058424，rs3763043 和 rs335931 多态性，并收集患者临床资料进行统计学分 析。结果：与对照组比较，病例组患者年龄较大，糖尿病、持续发热患者比例较高，基线血肿体积较大，基线 NIHSS评分较高（均P＜0.05）。病例组rs3763043位点TT基因型和T等位基因分布频率较对照组均显著增 加（均P＜0.05）。回归分析结果显示，对于HICH患者，携带AQP4基因rs3763043位点T等位基因、发热、血 肿体积偏大及NIHSS评分偏高可能是发生迟发型脑水肿的危险因素。结论：携带AQP4基因rs3763043位点 T等位基因、发热、血肿体积偏大及NIHSS评分偏高可能是HICH患者发生迟发型脑水肿的危险因素。

To investigate the association between aquaporin 4 (AQP4) gene polymorphism and delayed cerebral edema in patients with hypertensive intracerebral hemorrhage (HICH) in Shanxi. Methods: One hundred and thirty-seven HICH patients in Shanxi were recruited to the study. According to whether combined with delayed cerebral edema, they were divided into the case group (42 cases) and the control group (95 cases). Genotype was determined by polymerase chain reaction- sequence based typing for AQP4 gene rs1058424, rs3763043, and rs335931 polymorphism. In addition, other clinical data were collected for statistical analysis. Results: Compared to the control group, the case group showed higher age, higher ratio of patients with diabetes and persistent fever, greater baseline hematoma volume, and higher baseline National Institute of Health Stroke Scale (NIHSS) score (all P<0.05). Compared with the control group, frequencies of genotype TT and allele T of rs3763043 in the case group were both significantly increased (both P<0.05). Multivariate logistic regression analysis showed that carrying allele T of AQP4 gene rs3763043, fever, large hematoma volume, and high NIHSS score were risk factors of delayed cerebral edema for HICH patients. Conclusion: For HICH patients in Shanxi, carrying allele T of the AQP4 gene rs3763043, fever, large hematoma volume, and high NIHSS score were risk factors of delayed cerebral edema.