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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 systematically evaluate the clinical application of lysophosphatidic acid (LPA) in ischemic stroke and explore its significance as an early warning indicator of the disease. Methods PubMed, Cochrane Library, Chinese Biomedical Literature Database, Chinese Journal Full-text Database, Wanfang Database and Chinese Science and Technology Periodical Database were retrieved electronically. The search time was from the database to June 2009. The literature was selected according to inclusion and exclusion criteria, and the quality was evaluated and data extracted. Qualitative analysis was performed using descriptive analysis, and quantitative analysis was performed using RevMan 4.2 software for meta-analysis. Results A total of 22 case-control studies were included. The quality of the study was Grade C Meta-analysis showed that there were significant differences in total LPA level, LPA level at 24h and LPA levels between transient ischemic group and healthy control group in cerebral infarction group and healthy control group: LPA level of WMD and The 95% CIs were 2.00 (1.85, 2.15), 2.40 (1.81, 2.99) and 2.48 (2.18, 2.78), respectively. Conclusions The results of this study suggest that LPA levels in patients with cerebral infarction are higher than those in healthy controls. It is of clinical significance to detect LPA levels in patients with transient ischemic attacks and to intervene. Due to the heterogeneity among the studies and poor methodology, the above conclusion still needs to be studied in a large number of high-quality studies to further confirm its significance as an early warning indicator.