血液内溶血磷脂酸浓度与氯吡格雷治疗短暂性脑缺血发作疗效的关系  

Relationship between efficacy of clopidogrel in treatment of TIA and concentration of plasma lysophosphatidic acid

作　　者：孙永安[1] 徐武华[2] 徐俊[3] 朱飞奇[4] 都爱莲[5] 郝红军[1] 王燕华[1] 伍期专[1] 

机构地区：[1]北京大学第一医院神经内科,北京100034 [2]广州市红十字会医院神经内科 [3]南京医科大学附属脑科医院 [4]郧阳医学院附属太和医院神经内科 [5]浙江大学医学院附属第二医院

出　　处：《中华老年心脑血管病杂志》2009年第4期275-277,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家重点基础研究发展规划"973"基金(G20000569050)

摘　　要：目的探讨血液内溶血磷脂酸(lysophosphatidic acid,LPA)浓度与氯吡格雷治疗短暂性脑缺血发作(transi-ent ischemic attack,TIA)疗效的关系。方法选择TIA患者77例,根据血液内LPA浓度分为LPA增高组(>3.2μmol/L,49例)和LPA正常组(≤3.2μmol/L,28例),用氯吡格雷75 mg/d进行治疗,随访1个月,观察TIA患者的发作频率以及发展成为脑梗死的发生率。结果 LPA增高组患者治疗前和治疗后LPA浓度明显高于LPA正常组,LPA增高组患者治疗后LPA浓度较治疗前明显降低(P<0.05)。经过1个月的氟吡格雷治疗,LPA增高组患者中,1个月内平均发作(1.53±0.34)次,共有8例发展成为脑梗死,发生率为16.3%,而LPA正常组患者中,1个月内平均发作(2.17±0.52)次,有7例发展成为脑梗死,发生率为25.0%。结论氯吡格雷治疗高血浓度LPA的TIA患者疗效优于正常血浓度LPA的TIA患者。Objective To study the relationship between efficacy of clopidogrel in treatment of transient ischemie attack （TIA）and the concentration of plasma lysophosphatidic acid （LPA）. Methods Seventy-seven patients with definite TIA were divided into two groups according to the level of plasma LPA. The group of high-level LPA included 49 patients and the normal LPA group included 28. Each group was treated with clopidogrel tablets. After the treatment for one month, the frequency of TIA and incidence of cerebral infarction were observed. Results Both before and after the treatment with clopidogrel,the group of high plasma LPA had significant higher LPA concentration than the normal LPA group. After the treatment,the concentration of plasma LPA significantly decreased in the high LPA group. The group of high level LPA developed （1.53±0.34）times of TIA and the group of normal LPA had（2. 17±0.52） times. In the 49 patients with high level LPA,8 patients developed cerebral infarction after one month of treatment, and in the 28 patients with normal LPA,there were 7. Conclusion The efficacy of clopidogrel in the treatment of TIA is better in patients with high level plasma LPA than in patients with normal plasma LPA level.

关 键 词：脑缺血发作 短暂性 溶血磷脂素类 血小板聚集抑制剂 抗凝药 

分 类 号：R743.3[医药卫生—神经病学与精神病学]