厄贝沙坦对急性脑梗死患者血浆溶血磷脂酸、内皮素-1和血清一氧化氮含量的影响

目的研究厄贝沙坦对急性脑梗死患者血浆溶血磷脂酸（LPA）、内皮素-1（ET-1）和血清一氧化氮（NO）含量的影响。方法将53例急性脑梗死患者随机分为厄贝沙坦治疗组（25例）和常规治疗组（28例）,并以23例非脑血管病患者和7名健康志愿者作为对照组。厄贝沙坦治疗组给予厄贝沙坦150mg＋阿司匹林100mg,常规治疗组给予阿司匹林100mg,每天1次,其余治疗方法相同,连续治疗14d。分别在治疗前后抽取静脉血检测LPA、ET-1和NO含量,并对两脑梗死组治疗前后进行神经功能缺损程度评分（NDS）。结果（1）脑梗死患者血LPA、ET-1含量较对照组显著升高（均P〈0.05）,NO含量显著降低（P〈0.05）;NDS与NO含量呈负相关（r=-0.4345,P〈0.05）。（2）厄贝沙坦治疗组和常规治疗组治疗后血LPA、ET-1含量和NDS较治疗前显著降低（均P〈0.05）,NO含量显著升高（均P〈0.05）。（3）治疗后厄贝沙坦治疗组与常规治疗组相比,血LPA、ET-1、NO含量改善更为明显（均P〈0.05）。结论厄贝沙坦能显著降低急性脑梗死患者血LPA、ET-1含量,提高血NO水平,显示其有抗血小板活化及内皮保护作用。

Effects of Irbesartan on the plasma concentrations of lysophosphatidic acid, endothelin-1, and serum concentration of nitric oxcide in the patients with acute cerebral infarction

Objective To explore the effects of Irbesartan on the plasma concentrations of lysophosphatidic acid(LPA), endothelin-1(ET-1),serum concentration of nitric oxcide (NO) in the patients with acute cerebral infarction(CI).Methods All of the 53 patients were randomly assigned to Irbesartan therapy group(n=25) treated with Irbesartan 150 mg/d and Aspirin 100 mg/d and conventional therapy group(n=28) treated with Aspirin 100 mg/d.Both groups were treated for 14 days and the other measures of symptomatic therepy were the same. And another 23 patients without cerebrovascular diseases and 7 health volunteers were taken as control group.The venous blood samples were taken for measureing the levels of LPA,ET-1,NO while the scorces of neurological deficit (NDS)were evaluated before and after treatment. Results (1)Before treatment the levels of LPA,ET-1 in CI group were significantly higher and the level of NO was significantly lower than that in control group (all P<0.05) and the NDS was negatively related with the NO expression in CI group(r=-0.4345,P<0.05).(2)After treatment the levels of LPA,ET-1,NDS were significantly lower and the level of NO was significantly higher than that before treatment in both CI groups(all P<0.05).(3)Compared with the conventional therapy group the indexs of LPA,ET-1,NO were improved more significantly in Irbesartan therapy group (all P<0.05).Conclusion Irbesartan further decreased the levels of LPA,ET-1 and increase the level of NO which implies the role of Irbesartan on inhibiting platelet activation and endothelial protection in the patients with acute CI.