缺血性脑血管病与血浆溶血磷脂酸的临床研究  

Clinical investigation of plasma lysophosphatidic acid in patients with ischemic cerebrovascular

作　　者：陆景红[1] 周颖[1] 李宗友[1] 王幼萌[1] 许静[1] 尚志红[1] 王建华[2] 汝宁[1] 张艳[1] 杨程[1] 涂锋[1] 陈建[1] 云宗金[1] 许辉[1] 

机构地区：[1]阜阳市人民医院神经内科,236004 [2]阜阳市人民医院检验科,236004

出　　处：《安徽医学》2010年第9期1023-1026,共4页Anhui Medical Journal

基　　金：安徽省阜阳市卫生局科研基金课题(编号06001)

摘　　要：目的观察短暂性脑缺血发作(TIA)、脑梗死和进展性脑梗死患者血浆溶血磷脂酸(LPA)及酸性磷脂酸(acidphospholipids,AP)的变化,探讨其在缺血性脑血管病发生发展以及早期诊断和预后中的临床意义,为制定干预措施提供依据。方法以定磷方法测定LPA及AP水平。将研究对象分为TIA组(30例)、脑梗死组(30例)、进展性脑梗死组(15例)和对照组(30例),对不同组血清LPA及AP水平进行比较,并将脑梗死(脑梗死组和进展性脑梗死组)按神经功能缺损评分分为轻、中、重型3型,分析LPA及AP水平与病情轻重的相关性。结果 LPA水平在进展性脑梗死组最高(5.52±1.15)μmol/L,TIA组次之LPA(4.23±1.12)μmol/L,脑梗死组LPA水平较低(2.88±1.05)μmol/L,对照组最低LPA(1.22±0.67)μmol/L,经方差分析,组间比较有统计学意义(P<0.05);AP进展性脑梗死组最高(6.14±2.10)μmol/L,脑梗死组次之(5.74±2.10)μmol/L,TIA组(3.20±1.96)μmol/L和对照组(2.24±1.06)μmol/L(P<0.05);脑梗死按神经功能缺损3型间LPA及AP水平方差分析有统计学意义(P<0.05)。结论 LPA是体内凝血和血栓形成过程早期释放的分子标记物,可作为脑梗死的预警因子,尤其是进展性脑梗死的预警因子;LPA及AP水平与缺血性脑血管病类型有关,与病情轻重有一定相关性,可作为评估脑梗死诊断和预后的一个重要生物学指标。Objective To observe the value of Lysophosphatidic acid（LPA）in early diagnosis and treatment of ischemic disease.To explore the changes of plasma Lysophosphatidic acid（LPA）level and acid phospholipids（AP）level in patients with transient ischemic attacks（TIA）or cerebral infarction（CI）or progressive cerebral infarction,and to value the effect of those in the formation and progress of such diseases,in order to provide references in making intervening measurement.Methods Phospholipids was extracted by assaying its phosphorous component.75 patients were divided into three groups by the symptoms and signs：Transient ischemic attacks group（30 selected cases）,Cerebral infarction group（30 selected cases）,and progressive cerebral infarction group（15 selceted cases）and controi group（30 selected cases）.30 healthy person served as control.Cerebral infarction and Progressive cerebral infarction patients were divided into three types by neurologic impairment score.Results The content of LPA（5.52±1.15μmol/L）for Progressive cerebral infarction was the highest,while the content of LPA（4.23±1.12μmol/L）for TIA was followed by,the content of LPA（2.88±1.05μmol/L）on cerebral infarction and（1.22±0.67μmol/L）trat of control group,by analysis variance P〈0.05.The content of AP（6.14±2.10μmol/L）for Progressive cerebral infarction was the highest,while the content of AP（5.74±2.10μmol/L）for cerebral infarction was followed by,the content of AP（3.20±1.96μmol/L）on TIA and（2.24±1.06μmol/L）on control group,by analysis variance P〈0.05.Conclusion LPA was a molecular marker released by activated plateles in vivo and pre-warning factor of ischemic cerebrovascular,especially progressive cerebral infarction.LPA and AP levels had the relationship with the type of schemic cerebrovascular disease and the neurological impairment,LPA and AP levels are an important biomarker for diagnosing and predicting prognosis in the patients with cerebral infarction.

关 键 词：短暂性脑缺血发作 脑梗死 进展性脑梗死 溶血磷脂酸 

分 类 号：R743.3[医药卫生—神经病学与精神病学]