目的:探讨溶血磷脂酸在健康体检中的应用价值.方法:选取50岁以上有高血压、糖尿病、高脂血症其中之一项或多项的体检者200名,检测其血压、血糖、血脂、血浆LPA含量.随访观察6个月,每月测定血浆LPA、血糖、血脂各一次,高血压、糖尿病、高脂血症患者记录其控制血压、血糖、血脂的服药情况及治疗效果.以血浆LPA含量2.20 μmol·L-1为正常值的上限,分为LPA升高组与LPA正常组两组,以发生缺血性脑血管病为主要终点事件,以发生急性冠脉综合征或其它急性血栓性疾病为次要终点事件.以是否发生终点事件分组,比较两组间血浆LPA含量及血压、血糖、血脂的控制情况.结果: LPA升高组发生主、次要终点事件均高于LPA正常组,差异有统计学意义(P<0.01),其LPA值、收缩压、舒张压、空腹血糖、TC、TG、LDL均高于LPA正常组,HDL低于LPA正常组,差异有统计学意义(P<0.01).终点事件发生组事件发生前LPA值明显高于无终点事件发生组,其收缩压、舒张压、空腹血糖、TC、TG、LDL均显著高于无终点事件发生组,HDL低于无终点事件发生组,差异有统计学意义(P<0.01).结论:血压、血糖、血脂等卒中危险因素控制不良时,血浆LPA含量升高.血浆LPA含量越高提示发生缺血性脑血管病及其他急性血栓性疾病的风险越大.健康体检时检测血浆LPA含量有助于积极防治缺血性脑血管疾病.%Objective:To investigate clinical value of lysophosphatidic acid(LPA) in healthy physical examination.Methods: Totally 200 cases of patients over 50 years old were randomly selected, who had a disease with one or more symptoms of hypertension, diabetes, hyperlipidemia.The blood pressure, blood glucose, blood lipid, plasma LPA level of the patients were measured and recorded each month, lasting for 6 months.According to the normal cut-off value of plasma LPA 2.20 μmol·L-1, the patients were divided into the LPA increased group and the LPA normal group.Occurrence of ischemic cerebrovascular disease was regarded as primary endpoint event and occurrence of acute coronary syndrome or other acute thrombotic diseases as secondary endpoint events.The plasma LPA, blood pressure, blood glucose, blood lipid were compared between the two groups of patients with or without the occurrence of endpoint events.Results: A higher incidence of the primary and secondary endpoint events was observed in LPA increased group(P<0.01), and LPA value, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, TC, TG, LDL were also higher than those in LPA normal group, HDL was lower, the differences were all statistically significant (P<0.01).The content of plasma LPA before endpoint event occurred was significantly higher than that in none endpoint event group, and LPA value, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, TC, TG, LDL were also higher than those in none endpoint event group, HDL was lower, the differences were all statistically significant (P<0.01).Conclusion: Poor control of blood pressure, blood glucose, blood lipid and other risk factors for stroke can lead to the increasing of plasma LPA level.The higher is the plasma LPA level, the higher is the risk of ischemic cerebrovascular disease and other acute thrombotic diseases.To detect LPA level in healthy physical examination is helpful to treat ischemic cerebrovascular disease.
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