THE EFFECT OF APOE ON OUTCOMES IN TBI ADULTS

描述(改编自《调查者摘要》)：死亡率和 创伤性脑损伤患者的发病率仍然非常高。 很高。颅脑损伤引起的神经元损伤，表现为错位和致密 轴突内神经细丝和微管的弥散 影响神经传递。载脂蛋白E(ApoE)负责 脂类在大脑内的运输，有助于神经传递和 维持神经元内微管的结构完整性。这个 载脂蛋白E(ApoE)基因与微管再生和 神经元内的通透性导致脑水肿，这是主要的 对脑外伤后预后的影响。我们假设有APOE4的人 等位基因在重建微管方面的难度将比 那些没有APOE4等位基因的人，这种差异将在临床上观察到 表现为血流、代谢减少和神经传递改变。 因此，本研究的目的是检测载脂蛋白E基因及其在中国的分布。 与脑血管、代谢和神经递质反应的关系 和脑外伤后的功能结果。研究问题有：1)是 两组患者在颅内压、脑血流灌注等方面存在差异 血压，脑血流量，动-颈静脉氧分压差， 动-颈静脉血糖差、脑氧代谢和 颅脑损伤后前5天的乳酸/丙酮酸比值 在控制肝内胆汁淤积症治疗强度的同时，是否有APOE4等位基因？ 2)脑脊液中天冬氨酸和谷氨酸水平有差异吗？ 脑外伤后前5天的体液 没有APOE4等位基因？3)功能结果有差异吗？ (死亡率，以及使用格拉斯哥结果衡量的神经心理评估 量表、残疾评定量表和神经行为评定量表) 有无APOE4等位基因的患者在脑损伤后几个月？如果 假说得到了支持，大脑中存在遗传差异 脑外伤后组织代谢和血流反应对脑损伤的影响 结果，结果可能导致护理、医疗和医疗的新前景 药物疗法。

DESCRIPTION (As Adapted from the Investigator's Abstract): Mortality and morbidity of patients following a traumatic brain injury (TBI) remain extremely high. TBI induces neuronal injury as evidenced by a misalignment and compaction of the neurofilaments and dispersion of the microtubules within the axon that effect neurotransmission. Apolipoprotein E (ApoE) is responsible for the transportation of lipids within the brain, assists in neurotransmission and maintains the structural integrity of the microtubule within the neuron. The genotype for ApoE (APOE) has been linked to microtubule regeneration and permeability within the neuron contributing to brain edema, which plays a major role in outcomes after TBI. We hypothesize that individuals with the APOE4 allele will have greater difficulty in rebuilding microtubules as compared to those without APOE4 alleles and this difference will be observed by clinical manifestations of decreased flow, metabolism and altered neurotransmission. Thus, the purpose of this study is to examine APOE genotype and its relationship to the cerebrovascular, metabolic and neurotransmitter responses and functional outcomes following a TBI. The research questions are: 1) Is there a difference in the intracranial pressure (ICP), cerebral perfusion pressure, cerebral blood flow, arterial-jugular venous oxygen difference, arterial-jugular venous glucose difference, cerebral oxygen metabolism and lactate/pyruvate ratio during the first 5 days following TBI between patients with and without APOE4 alleles while controlling for intensity of ICP therapy? 2) Is there a difference in aspartate and glutamate levels in the cerebrospinal fluid during the first 5 days following TBI between those patients with and without APOE4 alleles? 3) Is there a difference in the functional outcomes (mortality, and neuropsychologic evaluation measured using the Glasgow Outcome Scale, Disability Rating Scale and the Neurobehavioral rating scale) at 3 and 6 months after TBI between patients with and without APOE4 alleles? If the hypotheses are supported and there are genetic differences in the brain's tissue metabolism and blood flow response following TBI that impact on outcomes, the results could lead to a new vista of nursing, medical and pharmacologic therapies.