目的　探讨载脂蛋白E(ApoE)基因多态性和动脉瘤性自发蛛网膜下腔出血 (SAH)预后的关系。 方法　对 10 4例动脉瘤性SAH患者采用哥拉斯格预后评分 (GOS) ,对伤后 3个月的恢复情况进行评估。测定患者的血脂ApoE基因多态性 ,通过限制性片段长度多态性而确定 (RFLP)。结果　病例组的基因型和等位基因频率与正常对照组无显著性差异 (P >0 .0 5 )。在 18例ApoE∈ 4等位基因携带者中有 5例 (2 7.8% )预后不良 ,明显高于非∈4等位基因携带者 (8.1% ,P =0 .0 32 ) ;单因素和多因素Logistic回归均提示仅∈ 4是预后不良的危险因素 (单因素OR =4 .34,P =0 .0 2 6 ;多因素OR =6 .95 ,P =0 .0 30 )。结论　APOE∈ 4等位基因是动脉瘤性SAH患者预后不良的危险因素。 Objective To investigate the relationship between the apolipoprotein E (ApoE) gene polymorphism and the prognosis of spontaneous subarachnoid hemorrhage (SAH). Methods The Glasgow Outcome Scale (GOS) was used in 104 patients with aneurysmal SAH to evaluate the recovery status at 3 months after injury. The patient’s lipid ApoE gene polymorphism was determined by restriction fragment length polymorphism (RFLP). Results There was no significant difference in the genotype and allele frequency between the case group and the normal control group (P> 0.05). Five out of 18 carriers of ApoE 4 alleles (2 7.8%) had a poor prognosis, which was significantly higher than that of non-el allele carriers (8.1%, P = 0.322). Single factor and multiple Logistic regression analysis showed that only ∈ 4 was a risk factor for poor prognosis (univariate OR = 4.34, P = .026; multivariate OR = 6.95, P = .030). Conclusion The APOE ε 4 allele is a risk factor for poor prognosis in patients with aneurysmal SAH.