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目的观察抗血小板药物阿司匹林和氯吡格雷对急性非心源性脑梗死患者血浆溶血磷脂酸(lysophosphatidic acid,LPA)水平的影响。方法选取急性脑梗死患者180例,随机分为阿司匹林组和氯吡格雷组,阿司匹林组在常规治疗的基础上加用拜阿司匹林0.1g,每天一次,氯吡格雷组在常规治疗的基础上加用氯吡格雷75mg,每天一次。两组分别于治疗前和治疗后第12～14天测定血浆LPA。另设正常对照组50名,均为我院健康体检者。结果脑梗死组LPA水平明显高于对照组(3.80±0.87μmol/L vs 2.85±0.65μmol/L,P<0.01);与治疗前相比,阿司匹林组和氯吡格雷组治疗后LPA水平均明显降低(3.26±0.50μmol/L vs 3.79±0.83μmol/L,P<0.01;3.06±0.69μmol/L vs 3.82±0.90μmol/L,P<0.01),但氯吡格雷组降低更明显(P<0.01)。结论急性脑梗死患者血中LPA水平高于正常人;抗血小板药物阿司匹林、氯吡格雷均能显著降低急性脑梗死患者LPA,其中氯吡格雷较阿司匹林更明显。
Objective To investigate the effects of antiplatelet drugs aspirin and clopidogrel on plasma lysophosphatidic acid (LPA) levels in patients with acute non-cardiac infarction. Methods A total of 180 patients with acute cerebral infarction were randomly divided into aspirin group and clopidogrel group. Aspirin group was given 0.1g aspirin once a day on the basis of routine treatment. The clopidogrel group was added on the basis of routine treatment Clopidogrel 75mg, once daily. Plasma LPA was measured in both groups before and 12 to 14 days after treatment. Another set of normal control group of 50, are healthy in our hospital examination. Results LPA levels in cerebral infarction group were significantly higher than those in control group (3.80 ± 0.87μmol / L vs 2.85 ± 0.65μmol / L, P <0.01). LPA levels in aspirin group and clopidogrel group were significantly higher than those before treatment (3.26 ± 0.50μmol / L vs 3.79 ± 0.83μmol / L, P <0.01; 3.06 ± 0.69μmol / L vs 3.82 ± 0.90μmol / L, P <0.01), but the reduction was more obvious in the clopidogrel group (P < 0.01). Conclusion LPA levels in patients with acute cerebral infarction are higher than those in normal people. Antiplatelet drugs aspirin and clopidogrel can significantly reduce LPA in patients with acute cerebral infarction. Clopidogrel is more obvious than aspirin.