抗血小板药物对急性非心源性脑梗死患者血浆溶血磷脂酸的影响

目的 观察抗血小板药物阿司匹林和氯吡格雷对急性非心源性脑梗死患者血浆溶血磷脂酸（lysophosphatidic acid，LPA）水平的影响。方法 选取急性脑梗死患者180例，随机分为阿司匹林组和氯吡格雷组，阿司匹林组在常规治疗的基础上加用拜阿司匹林0.1g，每天一次，氯吡格雷组在常规治疗的基础上加用氯吡格雷75mg，每天一次。两组分别于治疗前和治疗后第12～14天测定血浆LPA。另设正常对照组50名，均为我院健康体检者。结果 脑梗死组LPA水平明显高于对照组（3.80±0.87μmol/L vs 2.85±0.65μmol/L，P <0.01）;与治疗前相比，阿司匹林组和氯吡格雷组治疗后LPA水平均明显降低（3.26±0.50μmol/L vs 3.79±0.83μmol/L，P <0.01；3.06±0.69μmol/L vs 3.82±0.90μmol/L，P <0.01），但氯吡格雷组降低更明显（P <0.01）。结论 急性脑梗死患者血中LPA水平高于正常人；抗血小板药物阿司匹林、氯吡格雷均能显著降低急性脑梗死患者LPA，其中氯吡格雷较阿司匹林更明显。

Effects of Antiplatelet Drugs on Plasma Lysophosphatidic Acid in Patients with Acute non-cardiogenic Cerebral Infarction

Objective To observe the effect of antiplatelet drugs aspirin and clopidogrel on Plasma lysophospholipids acid levels （LPA） in patients with acute non-cardiogenic cerebral infarction. Methods A total of 180 patients with cerebral infarction （cerebral infarction group） and 50 healthy adults （control group） were tested for LPA level, and 180 patients with cerebral infarction were randomly assigned to aspirin group （n=90） and clopidogrel group （n=90）. Aspirin group based on routine therapy combined with bayaspirin, once a day, 0.1g; clopidogrel group based on routine therapy combined with clopidogrel, once a day, 75rag. Two groups were tested for the LPA level respectively before and after the first 12-14 days of the treatment. Results The LPA level in cerebral infarction group is significantly higher than that of the control group（3.80±0.87μmol/L vs 2.85±0.65μmol/L, P〈0.01）. The LPA level after the treatment are significantly reduced compared with former treatment in both aspirin group and clopidogrel group （3.26±0.50μtmol/L vs 3.79±0.83μtmol/L, P〈0.01; 3.06±0.69μmol/L vs 3.82±0.90μmol/L, P〈0.01）. The LPA level in clopidogrel group is lower than that of the aspirin group（P〈0.01）. Conclusion Plasma LPA in patients with acute cerebral infarction is higher than that of the normal ; Antiplatelet drugs aspirin and clopidogrel can significantly reduce the LPA level of patients with acute cerebral infarction, and the effect of clopidogrel is more obvious than that of aspirin.