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目的探讨溶血磷脂酸(LPA)对急性缺血性脑血管病的临床应用价值和预警作用的可行性。方法采用随机分组对照设计:①短暂性脑缺血发作(TIA)者Ⅰ组;②急性脑梗死(ACI)者Ⅱ组;③有缺血性脑血管病前期表现者Ⅲ组;④有高血压、高血脂、高血糖、高血黏度等相关危险因素而无前期表现者Ⅳ组。分别检测LPA并进行临床观察。结果Ⅰ组20例,LPA异常9例;Ⅱ组167例,LPA正常组临床好转率(87.8%)高于LPA异常组(77.2%),LPA正常组临床加重率(4.55%)低于LPA异常组(11.88%),组间比较差异有统计学意义(P<0.05);Ⅲ组294例,LPA异常189例,经药物干预后发生脑卒中1例,对照组LPA异常164例,未经干预,发生脑卒中29例,组间对比差异有统计学意义(P<0.01);Ⅳ组121例,LPA异常79例,经干预后未发生脑卒中。结论TIA病情的加重与LPA升高有关。ACI病情变化与LPA呈明显的正相关。LPA的预警作用是切实可行的。
Objective To investigate the clinical value and early warning effect of lysophosphatidic acid (LPA) on acute ischemic cerebrovascular disease. Methods The randomized controlled trials were designed: ① group Ⅰ with transient ischemic attack (TIA); ② group Ⅱ with acute cerebral infarction (ACI); ③ group Ⅲ with ischemic cerebrovascular disease , Hyperlipidemia, hyperglycemia, high blood viscosity and other related risk factors without prior performance in group Ⅳ. LPA were detected and clinical observation. Results In group Ⅰ, there were 20 cases with abnormal LPA, and 167 cases in group Ⅱ, the clinical improvement rate (87.8%) in LPA normal group was higher than that in LPA abnormal group (77.2%), while the LPA normal group (4.55%) was lower than LPA abnormality Group (11.88%), the difference between the two groups was statistically significant (P <0.05); Group Ⅲ 294 cases, 189 cases of LPA abnormalities, stroke occurred after drug intervention in 1 case, 164 cases of LPA abnormalities in the control group without intervention (P <0.01). There were 121 cases in group Ⅳ and 79 cases of abnormal LPA. No stroke occurred after intervention. Conclusion The exacerbation of TIA is related to the increase of LPA. The change of ACI was positively correlated with LPA. LPA early warning effect is feasible.