中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2010年
1期
16-18
,共3页
王道珍%李振光%王远臣%迟相林
王道珍%李振光%王遠臣%遲相林
왕도진%리진광%왕원신%지상림
分水岭脑梗死%溶血磷脂素
分水嶺腦梗死%溶血燐脂素
분수령뇌경사%용혈린지소
Cerebral watershed infarction%Lysophosphatidic acid
目的 探讨老年分水岭脑梗死(CWI)的类型、临床特点及与血浆溶血磷脂酸(LPA)水平的关系.方法 分析106例经头颅MRI证实为CWI患者(CWI组)的临床资料,比较不同类型CWI患者与36例非CWI患者(非CWI组)及32例门诊健康查体者(健康对照组)血浆LPA水平的变化.结果 CWI组中皮层前型22例,血浆LPA水平为(4.93±0.72)μmol/L;皮层后型17例,血浆LPA水平为(4.75±0.81)μmol/L;皮层下型47例,血浆LPA水平为(5.46±1.03)μmol/L;混合型20例,血浆LPA水平为(6.02±1.12)μmol/L.非CWI组血浆LPA水平为(5.37±1.24)μmol/L;健康对照组血浆LPA水平为(2.92±0.36)μmol/L.不同类型CWI患者与健康对照组比较,血浆LPA水平均明显升高,差异有统计学意义(P<0.05或<0.01),其中混合型最高,皮层下型次之,混合型与皮层前型及皮层后型比较差异有统计学意义(P<0.05);非CWI组血浆LPA水平明显高于健康对照组,但与不同类型CWI患者比较差异无统计学意义.结论 老年CWI以皮层下型为主,病因主要为动脉粥样硬化斑块形成及血管腔狭窄,血小板活化及其产生的微栓子在老年CWI的病理生理学中发挥重要作用;LPA水平在老年不同类型CWI患者血浆中均明显增高,其中又以混合型最高,可作为重要的分子标志物指导老年CWI的分型治疗.
目的 探討老年分水嶺腦梗死(CWI)的類型、臨床特點及與血漿溶血燐脂痠(LPA)水平的關繫.方法 分析106例經頭顱MRI證實為CWI患者(CWI組)的臨床資料,比較不同類型CWI患者與36例非CWI患者(非CWI組)及32例門診健康查體者(健康對照組)血漿LPA水平的變化.結果 CWI組中皮層前型22例,血漿LPA水平為(4.93±0.72)μmol/L;皮層後型17例,血漿LPA水平為(4.75±0.81)μmol/L;皮層下型47例,血漿LPA水平為(5.46±1.03)μmol/L;混閤型20例,血漿LPA水平為(6.02±1.12)μmol/L.非CWI組血漿LPA水平為(5.37±1.24)μmol/L;健康對照組血漿LPA水平為(2.92±0.36)μmol/L.不同類型CWI患者與健康對照組比較,血漿LPA水平均明顯升高,差異有統計學意義(P<0.05或<0.01),其中混閤型最高,皮層下型次之,混閤型與皮層前型及皮層後型比較差異有統計學意義(P<0.05);非CWI組血漿LPA水平明顯高于健康對照組,但與不同類型CWI患者比較差異無統計學意義.結論 老年CWI以皮層下型為主,病因主要為動脈粥樣硬化斑塊形成及血管腔狹窄,血小闆活化及其產生的微栓子在老年CWI的病理生理學中髮揮重要作用;LPA水平在老年不同類型CWI患者血漿中均明顯增高,其中又以混閤型最高,可作為重要的分子標誌物指導老年CWI的分型治療.
목적 탐토노년분수령뇌경사(CWI)적류형、림상특점급여혈장용혈린지산(LPA)수평적관계.방법 분석106례경두로MRI증실위CWI환자(CWI조)적림상자료,비교불동류형CWI환자여36례비CWI환자(비CWI조)급32례문진건강사체자(건강대조조)혈장LPA수평적변화.결과 CWI조중피층전형22례,혈장LPA수평위(4.93±0.72)μmol/L;피층후형17례,혈장LPA수평위(4.75±0.81)μmol/L;피층하형47례,혈장LPA수평위(5.46±1.03)μmol/L;혼합형20례,혈장LPA수평위(6.02±1.12)μmol/L.비CWI조혈장LPA수평위(5.37±1.24)μmol/L;건강대조조혈장LPA수평위(2.92±0.36)μmol/L.불동류형CWI환자여건강대조조비교,혈장LPA수평균명현승고,차이유통계학의의(P<0.05혹<0.01),기중혼합형최고,피층하형차지,혼합형여피층전형급피층후형비교차이유통계학의의(P<0.05);비CWI조혈장LPA수평명현고우건강대조조,단여불동류형CWI환자비교차이무통계학의의.결론 노년CWI이피층하형위주,병인주요위동맥죽양경화반괴형성급혈관강협착,혈소판활화급기산생적미전자재노년CWI적병리생이학중발휘중요작용;LPA수평재노년불동류형CWI환자혈장중균명현증고,기중우이혼합형최고,가작위중요적분자표지물지도노년CWI적분형치료.
Objective To study the clinical type and features of cerebral watershed infarction (CWI)in eldedy patients and its relationship with plasma lysophosphatidic acid(LPA).Method Analyzed the clinical data of 106 cases of CWI patients(CWI group)confirmed by cranial MRI,and compared plasma LPA levels in patients with different types of CWI,non-CWI patients(non-CWI group,36 cases)and healthy controls(control group,32 cases).Results In CWI group,anterior-cortex type 22 cases,LPA(4.93±0.72)μmol/L,posterior-cortex type 17 cases,LPA(4.75±0.81)μmoi/L,subcortical type 47 cases,LPA (5.46±1.03)μmol/L,mixed type 20 cages,LPA(6.02±1.12)μmol/L.In non-CWIgroup,LPA(5.37±1.24)μmol/L.In control group,LPA(2.92 ±0.36)μmol/L.The levels of LPA significandy increased in various types of CWI(P<0.05 or<0.01).of which mixed type and subcortical type were the highest,and the level of LPA in mixed type WaS higher than that in anterior-cortex type and posterior-cortex type(P<0.05).The level of LPA in non-CWI group was higher than that in control group,but there wss no significant difference compared with various types of CWI.Conclusions Subcortical type is the primal type in elderly CWI patients,the main cause of which is the atherosclerotic plaque formation and lumen stenosis.Platelet activation and its microemboli play an important role in the pathophysiology.LPA levels are significantly higher in various types of CWI,of which mixed type is the highest.LPA can be used as an important molecular marker to guide the sub-type treatment of CWI in elderly patients.
