溶血磷脂酸在缺血性脑卒中临床应用的系统评价  

The Clinical Application of Lysophosphatidic Acid for Cerebral Ischemic Stroke:A Systematic Review

作　　者：袁莎莎[1] 孟庆跃[1] 王健[1] 邱静梅[1] 

机构地区：[1]山东大学卫生管理与政策研究中心,济南250012

出　　处：《中国循证医学杂志》2010年第11期1316-1324,共9页Chinese Journal of Evidence-based Medicine

摘　　要：目的系统评价溶血磷脂酸(LPA)在缺血性脑卒中的临床应用,探讨其作为该疾病预警指标的意义。方法电子检索PubMed、Cochrane Library、中国生物医学文献数据库、中文期刊全文数据库、万方数据库和中文科技期刊数据库,检索时间均从建库至2009年6月。按照纳入与排除标准选择文献,评价质量和提取数据,定性分析采用描述性分析,定量分析采用RevMan 4.2软件进行Meta分析。结果共纳入22个病例对照研究,其研究质量均为C级。Meta分析结果显示,对于脑梗死组和健康对照组的总LPA水平,24h时LPA水平以及短暂性脑缺血组和健康对照组LPA水平比较,其差异均有统计学意义:LPA水平的WMD及95%CI分别为2.00(1.85,2.15),2.40(1.81,2.99)和2.48(2.18,2.78)。结论本研究结果提示,脑梗死患者的LPA水平高于健康对照组,在短暂性脑缺血期检测患者LPA水平并进行干预有一定的临床意义。由于各研究间存在异质性,且方法学质量较差,上述结论尚需开展大量高质量研究进一步证实其作为预警指标的意义。Objective To assess the clinical application of lysophosphatidic acid（LPA） as the early warning index for cerebral ischemic stroke（CIS）.Methods Trials were collected through electronic searches of PubMed,The Cochrane Library,CBM,CNKI,Wanfang,and VIP（from the date of database establishment to June 2009）.We screened the retrieved studies according to the prede ned inclusion and exclusion criteria,evaluated the quality of the included studies,performed descriptive analysis and meta-analysis with The Cochrane Collaboration’s RevMan 4.2 software.Results A total of 22 studies were included.The results of meta-analyses showed that,there was a signi cant di erence about LPA level in cerebral infarction（CI） group vs.healthy control group（WMD=2.00,95%CI 1.85 to 2.15）,and in transient ischemia attach（TIA） group vs.healthy control group（WMD=2.48,95%CI 2.18 to 2.78）;and a di erence was noted about 24？hours LPA level in CI group vs.healthy control group（WMD=2.40,95%CI 1.81 to 2.99）.Conclusions According to the included studies,the contents of LPA is higher in CIS than that in healthy control group.It would be helpful to measure LPA in the TIA period for intervention.However,more high quality trials are expected for further study,in order to prove the value of LPA as early warning index because of the heterogeneity and poor quality of the current included studies.

关 键 词：溶血磷脂酸(LPA) 缺血性脑卒中 脑梗死 META分析 

分 类 号：R743.3[医药卫生—神经病学与精神病学]