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目的测定在急性脑梗死患者血浆中溶血磷脂酸(LPA)的浓度,于开盲对照添加治疗中观察拜阿司匹林添加丁苯酞对血浆LPA水平的影响,并进行临床疗效评估。方法选择急性脑梗死患者120例,随机分为添加丁苯酞组(59例)和不添加丁苯酞治疗组(61例);同时选择门诊体检者为正常对照组(60名)。分别测定入院时和治疗后3 d、7 d、14 d的血浆LPA浓度,同时采用美国国立卫生研究所卒中量表进行评估临床病情严重程度和治疗效果。结果两组急性脑梗死患者血浆LPA的水平明显增高,与正常对照组比较,差异有显著统计学意义(P<0.01);添加丁苯酞组和不添加丁苯酞组血浆LPA水平在治疗后3 d和7 d逐渐下降,14 d基本降至正常水平,两组患者治疗后神经功能缺损程度均有改善,但添加丁苯酞组优于不添加丁苯酞组,组间比较治疗3 d、7 d、14 d均差异有显著统计学意义(P<0.01)。结论在急性脑梗死治疗中添加丁苯酞可明显降低血浆LPA水平,并能改善临床神经功能缺损评分。
Objective To determine the concentration of lysophosphatidic acid (LPA) in the plasma of patients with acute cerebral infarction and to observe the effect of adding butylphthalide on the level of plasma LPA by adding aspirin in the open-blind control and evaluate the clinical efficacy. Methods One hundred and twenty patients with acute cerebral infarction were randomly divided into two groups: control group (60 cases) and butylphthalide group (61 cases). Plasma LPA concentrations were measured at admission and at 3 d, 7 d, and 14 d after treatment, respectively. The severity of the clinical condition and the therapeutic effect were also evaluated using the National Institutes of Health Stroke Scale. Results The levels of plasma LPA in both groups were significantly higher than those in the normal control group (P <0.01). The levels of plasma LPA in the patients with and without butylphthalide after treatment 3 d and 7 d gradually decreased, 14 d dropped to normal levels, the two groups of patients after treatment, neurological deficit improved, but add butylphthalide group was better than without butylphthalide group, the comparison between the treatment group 3 d , 7 d and 14 d respectively. There was significant difference between the two groups (P <0.01). Conclusion The addition of butylphthalide in the treatment of acute cerebral infarction can significantly reduce the plasma LPA level and improve the clinical neurological deficit score.