急性缺血性脑血管病血浆溶血磷脂酸和酸性磷脂水平的变化及意义

目的 探讨急性缺血性脑血管病患者血浆溶血磷脂酸(LPA)及酸性磷脂(AP)水平变化及临床意义.方法 急性缺血性脑血管病患者100例,根据脑血管病分类及临床诊断标准分为短暂性脑缺血发作组(TIA)、急性脑梗死组(ACI)；健康体检者50例为对照组.分别测定发病24小时内血浆LPA、AP水平.结果 TIA组血浆LPA、AP值较ACI组、对照组明显增高,差异有统计学意义(P＜0.01)；ACI组较对照组明显增高,差异有统计学意义(P＜0.01).不同梗死面积3组间比较,大梗死灶组较中小梗死灶组LPA、AP增高,LPA分别为(5.33±1.09)μmol/L vs (4.82±0.96) μmol/L vs (2.22±0.61) μmol/L,AP(6.51±1.33) μmol/L vs (4.86±1.04) μmol/L vs (2.01±0.44)μmol/L,差异统计学意义(P＜0.05或＜0.01).结论 血浆LPA、AP水平与血小板活化、血栓形成的危险程度及梗死灶大小相关,可以作为急性缺血性脑血管病预警因子,对其防治有重要临床应用价值.

Change and significance-of level of lysophosphatidic acid and acid phospholipid in acute ischemic cerebrovascular disease

Objective To investigate the changes and clinical meaning of lysophosphatidic acid（LPA） and acid phospholipid（AP） in acute ischemic cerebrovascular disease. Methods 100 cases with acute ischemic cerebrovascular disease were divided into transient ischemic attack group（TIA）, acute cerebral infarction group（ACI） according to the clinical diagnosis and cerebrovascular disease classification standard. And 50 healthy cases from body-check served for controls. The levels of plasma LPA and AP were detected in 24 hours after onset. Results Plasma LPA and AP were significantly different among the three groups, they were significantly higher in TIA group than those in ACI group （P 〈 0.01）. And the the two indexes in ACI group were significantly higher than those in control group （ P 〈0.01）. LPA （5.33± 1.09） μmol/L vs （4.82±0.96） μmol/L vs （2.22±0.61）μmol/L, AP （6.51±1.33） μmol/L vs （4.86±1.04） μmol/L vs （2.01 ±0.44） μmol/L respectively. In different infarct size among the three groups, the larger infarct group showed more increase in LPA, AP than the medium and small infarct group, the difference was statistically significant. Conclusion LPA and AP level were related to the risk of thrombosis and the infarction size, could serve as prognostic factors for cerebral infarction and they have clinical value in treating ischemic cerebrovascular disease.