血浆LP-PLA2、GMP、LPA及血小板活化指标与短暂性脑缺血发作的关系

Relationship of plasma levels of LP-PLA2,GMP,LPA and platelet activation markers with transient ischemic attack

目的:研究血浆脂蛋白相关性磷脂酶A2(LP-PLA2)、α-颗粒膜蛋白(GMP)、溶血磷脂酸(LPA)及血小板活化指标与短暂性脑缺血发作(TIA)的关系。方法:收集TIA患者87例,均接受奥扎格雷钠治疗(120mg/次,1次/d,连续治疗2周)。分别在发病24h内及治疗1、3、7、14d取空腹静脉血,采用流式细胞仪检测血小板活化功能的指标溶酶体膜蛋白(CD63)、血小板膜暴露纤维蛋白原受体(PAC-1)、血小板膜糖蛋白(GPⅡb/Ⅲa),并对血浆中LP-PLA2、GMP、LPA水平进行检测,分析上述指标的动态变化过程及在不同TIA人群间差异。结果:TIA患者(无论是颈动脉系统TIA或椎基动脉系统TIA)血浆LP-PLA2、GMP、LPA水平高于对照组(P<0.05),血小板活化标志物CD63、PAC-1、GpⅡb/Ⅲa表达率高于对照组(P<0.05)。TIA患者接受奥扎格雷钠治疗1d后血浆中LP-PLA2、GMP、LPA水平和血小板活化标志物CD63、PAC-1、GpⅡb/Ⅲa表达率开始逐渐下降,在治疗7d或14d时恢复正常。结论:血小板活化在TIA发生中起着重要作用,抗血小板治疗能有效抑制血小板活化,在TIA治疗中具有积极意义。

Objective：To explore the relationship of plasma levels of LP-PLA2,GMP,LPA and platelet activation markers with transient ischemic attack（TIA）.Methods：A total of 87 cases with TIA were collected,and all patients were treated with ozagrel（120mg/times/day for 2weeks）.Fasting blood were collected in 24 hafter attack and 7d,14 days after treatment respectively,then flow cytometry was used to detect indicators of platelet activation,such as CD63,PAC-1,GPⅡb/Ⅲa,and the plasma levels of LP-PLA2,GMP,LPA.The dynamic changes of the such indexes and the differences between different populations were analyzed.Results：The plasma levels of LP-PLA2,GMP,LPA and the platelet activation indexes including CD63,PAC-1,GPⅡb/Ⅲa of patients with TIA were all significantly higher than control group（all P0.05）.One day after treatment of sodium Ozagrel,the plasma levels of LP-PLA2,GMP,LPA and the platelet activation indexes such as CD63,PAC-1,GPⅡb/Ⅲa of patients with TIA began to decline,and returned to normal in the treatment of 7dor 14 d.Conclusions：Platelet activation plays an important role in the occurrence of TIA,and antiplatelet therapy can effectively inhibit platelet activation,which has positive significance in the treatment of TIA.