急性脑梗死患者血浆溶血磷脂酸水平与颈动脉粥样硬化特点的观察

The relationship between changes of plasma lysophosphatidic acid level and carotid atherosclerosis in patients with acute cerebral infarction

目的观测急性脑梗死(ACI)患者血浆溶血磷脂酸(LPA)水平与颈动脉粥样硬化斑块(CAS)的特点。方法 180例ACI患者均行颈动脉超声检查,测量双侧颈总动脉远端、颈动脉分叉处及颈内动脉起始段内—中膜厚度(IMT),观察有无粥样斑块并测量其大小。按结果分为CAS组62例(其中易损斑块32例,稳定斑块30例)、内膜增厚组48例及颈动脉正常组70例;并检测患者血浆LPA浓度,并与健康体检者50例进行对照。结果 ACI患者血浆LPA水平及IMT与对照组比较均明显升高,差异有统计学意义(P<0.01)。CAS组血浆LPA水平明显高于内膜增厚组高于颈动脉正常组(P均<0.01);易损斑块亚组的血浆LPA水平高于稳定斑块亚组(P<0.01)。结论 ACI患者血浆LPA水平增高,IMT增厚,LPA水平与颈动脉粥样硬化斑块的存在及其稳定性有关。

Objective To study the levels of plasma lysophosphatidic acid（LPA） and its clinical significance in patients with acute cerebral infarction（ACI） and its relationship with carotid atherosclerosis（CAS）.Methods All of the 180 ACI patients and the normal healthy group were tested by carotid ultrasonography.The intima-media thickness（IMT） of common carotid artery＇s dist,the bifurcation of carotid artery and the origin of the internal carotid artery were recorded.The plaques and their size were measured,then determined whether there was CAS or not,then they were divided into the CAS group（n =62,including 32 cases with vulnerable CAS and 30 cases with stable CAS）,intima thickening group（n=48）,and the normal group（n=70）.Compared with the normal healthy group,LPA was measured in 180 ACI patients.Results The LPA of ACI patients rose in the acute phase.The ACI group compared with the normal healthy group has significant difference （P〈0.01）.The LPA of the CAS group were higher than the other two groups（P〈0.01 ）.The plasma LPA in vulnerable CAS group were higher than that in stable CAS group（P〈0.01）.Conclusion The plasma LPA in the group of ACI was higher than the normal healthy group.The LPA might play a role in ACI development.There was a significant correlation between carotid atherosclerosis and LPA level in ACI.