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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 changes of plasma lysophosphatidic acid (LPA) and acid phospholipids (AP) in patients with transient ischemic attack (TIA), cerebral infarction and progressive cerebral infarction As well as the clinical significance of early diagnosis and prognosis, to provide the basis for the development of interventions. Methods The levels of LPA and AP were determined by the method of determining phosphorus. The subjects were divided into TIA group (30 cases), cerebral infarction group (30 cases), progressive cerebral infarction group (15 cases) and control group (30 cases). The levels of serum LPA and AP in different groups were compared, Cerebral infarction (cerebral infarction group and progressive cerebral infarction group) were divided into mild, moderate and severe type 3 according to neurological deficit score, and the correlation between the level of LPA and AP and severity was analyzed. Results The level of LPA was the highest (5.52 ± 1.15) μmol / L in cerebral infarction group, followed by LPA (4.23 ± 1.12) μmol / L in TIA group and 2.88 ± 1.05 μmol / L in cerebral infarction group The lowest LPA (1.22 ± 0.67) μmol / L in the AP group was the highest (6.14 ± 2.10) μmol / L in the AP progressive cerebral infarction group (5.74 ± 2.10) μmol / L, TIA group (3.20 ± 1.96) μmol / L and control group (2.24 ± 1.06) μmol / L respectively (P <0.05) The analysis was statistically significant (P <0.05). Conclusion LPA is a molecular marker for the early release of coagulation and thrombosis in vivo, which can be used as an early warning factor of cerebral infarction, especially for advanced cerebral infarction. LPA and AP levels are related to the type of ischemic cerebrovascular disease, Severity of a certain relevance, can be used as a diagnostic evaluation of cerebral infarction and prognosis of an important biological indicators.