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目的通过溶血磷脂酸(LPA)水平的变化,探讨进展性脑梗死发病机制及LPA临床意义。方法入选急性脑梗死患者102例,根据临床症状、体征有无进展分为进展性脑梗死组、非进展性脑梗死组。并入选50例健康者为对照组。分别测定血浆LPA浓度。结果进展性脑梗死组和非进展性脑梗死组的血浆LPA的比较:进展性脑梗死组血浆水平(9.61±2.09)μmol/L,非进展性脑梗死组(6.50±0.90)μmol/L,对照组(3.05±1.17)μmol/L,经方差分析,组间比较差异有统计学意义(P<0.0001)。结论溶血磷脂酸作为血小板活化程度的分子标记物,在进展性脑梗死的显著增高,提示进展性脑梗死最主要的发病机制是血栓形成。同时LPA能敏感的反映血小板的活化状态和血栓的进展情况,可作为脑梗死的预警因子,这对进展性脑梗死患者的临床诊治具有重要的参考价值。
Objective To investigate the pathogenesis of progressive cerebral infarction and the clinical significance of LPA by the changes of LPA level. Methods A total of 102 patients with acute cerebral infarction were enrolled and divided into progressive cerebral infarction group and non-progressive cerebral infarction group according to clinical symptoms and signs. Fifty healthy subjects were selected as control group. Plasma LPA concentrations were measured. Results Compared with plasma LPA in patients with progressive cerebral infarction and non-progressive cerebral infarction, plasma LPA levels in progressive cerebral infarction group (9.61 ± 2.09) μmol / L and non-progressing cerebral infarction group (6.50 ± 0.90) μmol / L, Control group (3.05 ± 1.17) μmol / L, by analysis of variance, the difference between the two groups was statistically significant (P <0.0001). Conclusion As a molecular marker of platelet activation, lysophosphatidic acid is significantly increased in progressive cerebral infarction, suggesting that the most important pathogenesis of progressive cerebral infarction is thrombosis. At the same time LPA can reflect the activation status of platelet and the progress of thrombus, which can be used as an early warning factor of cerebral infarction, which has an important reference value for the clinical diagnosis and treatment of patients with progressive cerebral infarction.