目的：分析自发性脑出血（ICH）患者的血肿扩大CT预测征象与载脂蛋白E（ApoE）基因型的相关性，以 探究ApoE基因在脑出血发展过程中的可能作用。方法：纳入我科2018年6月至2020年4月符合急性ICH诊 断且具有ApoE基因型检测结果的患者的临床资料和影像学资料。评估影像学资料，通过卡方检验及Logistic 回归分析CT征象与ApoE基因的相关性。结果：发病12 h和18 h内的征象中，ApoE基因?2携带与CT上的“黑 洞征”征象有关（P=0.009，P=0.030）；发病24 h内的征象中，ApoE基因?4携带与CT上的“血肿不均质密度”征象 有关（P=0.009）。Logistic回归分析结果显示，发病12及18 h内，?2等位基因携带是CT“黑洞征”独立预测因 素；发病24 h内，?4等位基因是CT上“血肿不均质密度征”的独立预测因素。结论：ApoE不同等位基因可能参 与血肿扩大，ApoE基因检测在脑出血患者诊治过程中具有重要意义。

We evaluated the CT imaging signs which could predict hematoma expansion of intracerebral hemorrhage (ICH) patients and analyzed the correlation between them and apolipoprotein E (ApoE) gene polymorphisms. We aim to explore the role of the ApoE gene in the development of ICH. Methods: We recruited patients diagnosed with acute ICH who were also genotyped for the ApoE gene in the Department of Neurology in our hospital from June 2018 to April 2020 and collected their clinical and imaging data. We evaluated the imaging data and performed the chi-square test and logistic regression analysis to examine the correlation between the CT imaging signs and the ApoE gene. Results: Our study found that the CT black hole sign within 12 hours and 18 hours of ICH onset was associated with the ?2 allele carrier (P=0.009, P=0.030). Heterogeneous density of the hematoma within 24 hours of onset was correlated with the ?4 allele carrier (P=0.009). Logistic regression analysis showed that, within 12 and 18 hours of onset, the ?2 allele carrier was an independent predictor of the black hole sign; within 24 hours, the ?4 allele carrier was an independent predictor of heterogeneous density of the hematoma. Conclu? sion: Different alleles of ApoE may be involved in hematoma enlargement, and ApoE gene detection is significant for the diagnosis and treatment of patients with ICH.