脑梗死患者血浆sCD40L和可溶性血管黏附分子水平的变化及意义

Change of plasma sCD40L and soluble vascular adhesion molecules level in patients with acute cerebral infarction and its clinical significance

目的探讨脑梗死患者血浆sCD40L含量变化及其与血管黏附分子的关系,以及对脑梗死发生、发展的影响。方法采用酶联免疫吸附法(ELISA)测定70例急性期脑梗死患者血浆sCD40L、可溶性细胞间黏附分子-1(sICAM-1)和血管细胞黏附分子-1(sVCAM-1)水平,并与30例其他疾病对照组及40例正常对照组比较。结果脑梗死患者血浆sCD40L水平(15.8±4.9)ng/mL,显著高于其他疾病对照组(4.4±2.5)ng/mL及正常对照组(3.5±1.7)ng/mL,差异有显著意义(P<0.01)。大梗死灶组血浆sCD40L(20.5±6.1)ng/mL明显高于中梗死灶组(14.8±4.9)ng/mL和小梗死灶组(11.5±4.0)ng/mL,P<0.01。sCD40L增高程度与神经功能缺损程度密切相关。合并高血压、糖尿病和吸烟患者血浆sCD40L水平明显高于非高血压、糖尿病和吸烟患者(P<0.01)。相关分析:脑梗死时sCD40L与可溶性细胞间黏附分子水平呈显著相关(r=0.593,P<0.01),与sVCAM-1呈正相关(r=0.109,P<0.05)。结论脑梗死患者血浆sCD40L水平显著升高,急性期监测血浆sCD40L水平变化有助于判断病情轻重和病灶大小。sCD40L可能通过上调血管细胞黏附分子表达参与了脑梗死炎症反应过程。

[Objective] To investigated the changes of plasma sCD40L and it＇s relationship with soluble vascular adhesion molecules, and effect of sCD40L on cerebral infarction. [Methods] Enzyme-Linked Immunosorbent Assay was used to detect the plasma sCD40L, soluble vascular cell adhesion molecule-1 and soluble intercellular adhesion molecules-1 of 70 patients with acute cerebral infarction as well as 30 patients with other cerebral neurologic disease and 40 normal controls. [Results] Plasma sCD40L level in acute cerebral infarction group （15.8±4.9） ng/mL were significantly higher than in patients with other cerebral neurologic disease group （4.4±2.5） ng/mL and normal controls （3.5±1.7） ng/mL, P 〈0.01. Plasma sCD40L level were significantly higher in the patients with large cerebral infarction [（20.5±6.1） ng/mL] than in the patients with medium [（14.8±4.9） ng/mL] and small cerebral infarction [（11.5±4.0） ng/mL], P 〈0.01. There was an obvious relationship between the degree of neurological deficits and plasma sCD40L level. In acute cerebral infarction group, sCD40L level of the patients with a history of hypertention, diabetes and cigarette smokers was significantly higher than those without the history of hypertention, diabetes and cigarette smokers （P 〈0.01）. Correlation analysis showed plasma sCD40L level was positively correlated with soluble vascular cell adhesion molecule-1 （r =0.593, P 〈0.01） and soluble intercellular adhesion molecules-1 level （r = 0.109, P 〈0.05）. [Conclusion] Plasma sCD40L level is significantly increased in the patients with acute cerebral infarction. The detection of plasma sCD40L will be helpful in estimating the clinican severity and infarct lesion at acute stage of cerebral infarction, sCD40L may participate in the inflammatory reaction process of cerebral infarction through up-regulating the adhesion molecules expression.