氯吡格雷对急性脑梗死患者血浆溶血磷脂酸水平的影响

The effects of clopidogrel on the LPA levels of patients with acute cerebral infarction

目的研究急性脑梗死患者血浆溶血磷脂酸(Lysophosphatidic acid,LPA)水平的变化及氯吡格雷对急性脑梗死患者血浆溶血磷脂酸水平的影响,探求急性脑梗死有效的干预方法。方法所有脑梗死患者随机分为氯吡格雷组及实验对照组,氯吡格雷组除给予脑梗死常规治疗外,加用氯吡格雷75mgqdpo,实验对照组只给予常规治疗。对急性脑梗死患者分别在治疗前、治疗3d及21d后进行血浆LPA水平的检测。结果氯吡格雷组治疗前及治疗21d后血浆LPA水平为:(4.82±1.10)和(2.23±0.96)μmol/L,两者相比有显著性差异(P<0.01);实验组治疗前及治疗21d后血浆LPA水平为(4.79±1.24)和(3.26±1.20)μmol/L,2者相比差异有显著性(P<0.01),两组治疗21d后血浆LPA水平相比差异有显著性(P<0.01)。皮层支氯吡格雷组治疗前及治疗21d后血浆LPA水平为:(5.59±1.08)和(2.62±1.03)μmol/L,2者相比差异有显著性(P<0.01);皮层支实验对照组治疗前及治疗21d后血浆LPA水平为:(5.55±0.96)和(4.01±0.75)μmol/L,2者相比差异有显著性(P<0.01),两组治疗21d后血浆LPA水平相比差异有显著性(P<0.01)。深穿支氯吡格雷组治疗前及治疗3d后血浆LPA水平为:(3.98±1.02)和(2.77±0.98)μmol/L,2者相比差异有显著性(P<0.01);深穿支实验对照组治疗前及治疗3d后血浆LPA水平分别为:(3.95±1.17)和(3.83±1.56)μmol/L,2者相比差异无显著性(P>0.01),两组治疗3d后血浆LPA水平相比差异有显著性(P<0.01)。结论氯吡格雷可降低急性脑梗死患者血浆LPA水平,对皮层支及深穿支梗死均有效,深穿支效果更佳。

Objective To investigate the changes of plasma Lysophposhatidic acid （LPA） levels in patients with acute cerebral infarction and to observe whether treatment with clopidogrel would reduce the LPA levels of patients with acute cerebral infarction. Methods All patients were randomized to clopidogrel group and control group. Patients in clopidogrel group were treated with normal method and clopidogrel （75mg/d）. Patients in control group were treated with only normal method. Plasma LPA levels were measured in all patients before treatment, 3 and 21 day after treatment. Results After 21 days of treatment, the levels of plasma LPA in clopidogrel group were lower than those in control group （P〈0.01）. In clopidogrel group the levels of plasma LPA in patients with cortical branch infarction were lower than those in control group after 21 days of treatment （P〈0.01）, and the levels of plasma LPA in patients with central branch infarction were lower than those in control group after 3 days of treatment （P〈0.01）. Conclusions Clopidogrel can effectively reduce plasma LPA levels of acute cerebral infarction.