摘要
目的:观察非瓣膜性心房颤动(NVAF)患者经阿司匹林和(或)阿托伐他汀干预后血浆溶血磷脂类分子(LPA/AP)含量的变化。方法:测定169例NVAF患者血浆溶血磷脂酸(LPA)及其相似总磷脂(AP)含量,并与124例正常对照者进行比较。169例NVAF患者随机分为NVAF对照组(n=52)、阿司匹林组(n=61)和阿司匹林+阿托伐他汀组(n=56),NVAF对照组不予任何处理,阿司匹林组予阿司匹林(100mg/d),阿司匹林加阿托伐他汀组予阿司匹林(100mg/d)和阿托伐他汀(10mg/d)。检测三组患者治疗前和治疗后3个月和1年时的血浆LPA/AP含量,观察3个月和1年时各组卒中发生情况。结果:NVAF患者血浆LPA及AP含量分别为(3.56±0.42)μmol/L和(6.12±0.57)U,显著高于正常对照者的(2.65±0.44)μmol/L和(4.68±0.45)U(P均<0.01)。治疗前、治疗后3个月和1年时,NVAF对照组血浆LPA含量分别为(3.61±0.49)、(3.52±0.51)和(3.66±0.59)μmol/L,AP分别为(6.23±0.59)、(6.47±0.61)和(6.36±0.79)U,无显著差异;阿司匹林组LPA分别为(3.53±0.46)、(3.12±0.62)和(2.94±0.60)μmol/L,AP分别为(6.37±0.66)、(5.64±0.52)和(5.33±0.61)U,治疗后LPA和AP均较治疗前显著下降(P<0.01);阿司匹林+阿托伐他汀组LPA分别为(3.59±0.33)、(2.58±0.50)和(2.46±0.48)μmol/L,AP分别为(6.19±0.53)、(4.98±0.50)和(4.64±0.58)U,治疗后LPA和AP均较治疗前显著下降(P<0.01),且较阿司匹林组下降更显著(P<0.01)。NVAF对照组、阿司匹林治疗组和阿司匹林+阿托伐他汀组3个月卒中发病例数分别为7、6和3例,1年时分别为16、11和6例,阿司匹林组和阿司匹林+阿托伐他汀组显著少于NVAF对照组(P<0.01),阿司匹林+阿托伐他汀组显著少于阿司匹林组(P<0.05)。结论:NVAF患者血浆LPA/AP含量显著升高,提示其体内血小板处于活化状态,NVAF患者存在缺血性膜损伤。阿司匹林或阿司匹林与阿托伐他汀联合应用均可显著降低NVAF相关性卒中的发生。NVAF患者在实施抗栓治疗时可考虑加
Objective： To observe the effect of aspirin/atorvastatin on the levels of plasma lysophosphatidic acid （LPA） or acidic phospholipids （AP） in patients with nonvalvular atrial fibrillation （NVAF）. Methods： The levels of plasma LPA/AP in 169 patients with NVAF and 124 normal controls were measured and compared. All the patients with NVAF were randomly allocated to NVAF control （n =52, did not give any treatment）, aspirin （n =61,100 mg/d）, and aspirin plus atorvastatin （n =56, aspirin 100 mg/d and atorvastatin 10 mg/d ） groups, The plasma LPA/AP levels in the three groups were measured at 3 and 12 months before and after the treatment,The occurrence of stroke was observed in all groups at 3 and 12 months. Results： The plasma LPA/AP levels in the NVAF group were 3.56±0.42 μmol/L and 6. 12 ± 0.57 U, respectively, They were significantly higher than 2.65 ± 0.44 μmol/L and 4. 68 ± 0.45 U in the normal control group （P all 〈 0.01）. The plasma LPA levels in the NVAF control group were 3.61 ± 0.49, 3.52 ± 0. 51, and 3.66 ± 0.59 μmol/L respectively, and the plasma AP levels were 6.23 ± 0. 59, 6.47 ± 0. 61, and 6.36 ± 0. 79 U respectively, and there were no significant difference, The plasma LAP levels in the aspirin group were 3.53 ± 0.46, 3.12 ± 0.62 and 2.94 ±0.60 μmol/L respectvely, and the AP levels were 6. 37 ±0.66, 5.64 ±0. 52 and 5.33 ± 0.61 U, respectively. Both the levels of LPA and AP after the treatment were decreased more significantly than before the treatment （P 〈 0.01 ）. The plasma LPA levels in the aspirin plus atorvastatin group were 3.59 ± 0.33, 2.58 ± 0. 50, and 2.46 ± 0.48 μmol/L respectively, and the AP levels were 6. 19 ± 0. 53, 4.98 ± 0. 50, and 4. 64 ± 0.58 U, respectively. Both the levels of LPA and AP after the treatment were decreased more significantly than before the treatment （P 〈 0.01 ）, and they were also decreased more significantly than those in the aspirin group （P 〈0.01）. The incidence number of stroke at 3 mo
出处
《中华脑血管病杂志（电子版）》
2008年第2期65-69,共5页
Chinese Journal of Cerebrovascular Diseases(Electronic Edition)
基金
国家"973"基金资助项目(G2000056905)
