摘要
目的:观察非瓣膜性心房颤动患者经阿托伐他汀干预后血浆溶血磷脂类分子含量的变化。方法:测定180例非瓣膜性心房颤动患者血浆溶血磷脂酸及其相似总磷脂含量,并与100例正常对照者进行比较。180例非瓣膜性心房颤动患者随机分为常规治疗组和阿托伐他汀组,检测各组患者治疗前和治疗后3个月和1年时的血浆溶血磷脂类含量,观察卒中发生情况。结果:非瓣膜性心房颤动患者血浆溶血磷脂酸及总磷脂含量显著高于正常对照者(P均<0.01)。治疗前、治疗后3个月和1年时,常规治疗组治疗后溶血磷脂酸和总磷脂均较治疗前显著下降(P<0.01);阿托伐他汀组治疗后溶血磷脂酸和总磷脂均较治疗前显著下降(P<0.01),且较常规治疗组下降更显著(P<0.01)。常规治疗组和阿托伐他汀组3个月卒中发病例数分别为6和3例,1年时分别为11和6例,阿托伐他汀组显著少于常规治疗组(P<0.05)。结论:非瓣膜性心房颤动患者血浆溶血磷脂类含量显著升高,提示其体内血小板处于活化状态,非瓣膜性心房颤动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非瓣膜性心房颤动相关性卒中的发生。
Objective To observe the effect of atorvastatin on the levels of plasma lysophospholipids in patients with nonvalvular atrial fibrillation. Methods The levels of plasma lysophospholipids in 180 patients with nonvalvular atrial fibrillation and 100 normal controls were measured and compared. All the patients with nonvalvular atrial fibrillation were randomly divided into conventional therapy group and atorvastatin therapy group. The plasma lysophospholipids levels in all groups were measured in 3 and 12 months before and after the treatment. The occurrence of stroke was observed in all groups in 3 and 12 months. Results The plasma lysophospholipids levels in the nonvalvular atrial fibrillation group were significantly higher than in normal control group （P〈0.01 all）. And they decreased more significantly after the treatment than before the treatment （P〈0.01）, and also decreased more significantly in the atorvastatin therapy group than the conventional therapy group （P〈0.01）. The incidence number of stroke in 3 months in the conventional therapy and atorvastatin therapy groups were 6 and 3 cases respectively, and 11 and 6 cases in 12 months, respectively（P〈0.05）. Conclusion The plasma lysophospholipids levels in patients with nonvalvular atrial fibrillation are elevated significantly. The platelets in vivo are in a condition of activation, and the patients with nonvalvular atrial fibrillation have ischemic membrane injury. Aspirin or aspirin plus atorvastatin significantly decreases the occurrence of the nonvalvular atrial fibrillation-associated stroke.
出处
《中华实用诊断与治疗杂志》
2008年第10期736-738,741,共4页
Journal of Chinese Practical Diagnosis and Therapy
