急性脑梗死患者白细胞变形能力、粘附功能和粘附分子表达的变化

The changes of leukocyte deformability and leukocyte adhesion function and expression of cell adhesion molecules in patients with acute cerebral infarction

目的探讨白细胞变形能力、粘附功能和白细胞粘附分子与急性脑梗死发生的关系。方法检测了６８例急性脑梗死患者急性期（发病３、７、１５天）和恢复期（２１、３０天）、４２例脑出血患者和６０名健康人外周血白细胞滤过指数（ＬＦＩ）、白细胞粘附率（ＬＡＲ）、白细胞ＣＤ１８表达和血清可溶性细胞间粘附分子１（ｓＩＣＡＭ１）浓度变化。结果急性脑梗死患者ＬＦＩ、ＬＡＲ、ＣＤ１８表达和ｓＩＣＡＭ１浓度均明显增高，与对照组和脑出血组比较差异有显著意义；脑梗死患者恢复期ＬＦＩ、ＬＡＲ、ＣＤ１８表达和ｓＩＣＡＭ１浓度明显低于急性期。随着病情好转，ＬＦＩ、ＬＡＲ、ＣＤ１８表达和ｓＩＣＡＭ１浓度逐渐降低，第３、７、１５、２１、３０天各指标比较差异有极显著意义。有并发症者各指标变化较无并发症者更明显。急性脑梗死患者ＬＦＩ、ＬＡＲ与ＣＤ１８表达和ｓＩＣＡＭ１浓度呈正相关。ＬＦＩ与ＬＡＲ呈正相关。结论急性脑梗死患者白细胞变形能力降低、粘附功能和ＣＤ１８表达及可溶性细胞间粘附分子１浓度增高，可能与急性脑梗死的发生。

Objective To explore the leukocyte deformability (LD), leukocyte adhesion function (LAF), expression of leukocyte CD18 expression and cell adhesion molecules (CAM) and acute cerebral infarction(ACI).Methods The leukocyte filtration index (LFI), leukocyte adhesion rate (LAR), leukocyte CD18 expression and serum soluble intercellular adhesion molecule1 (sICAM1) concentration were measured in 68 ACI patients with onset and remission stages, 42 cerebral hemorrhage and 60 controls. Results The LFI, LAR, leukocyte CD18 expression and sICAM1 concentration were significantly higher in ACI patients than those in controls and cerebral hemorrhage patients (P<0001). The LFI, LAR, CD18 expression and sICAM1 concentration were significantly lower in remission stage than those in onset stage (P<0.001). Along with the better of the patients' condition, the dicrease of all indicators in 3rd, 7th, 15th, 21st, 30th days were more obvious (P<001), and the all indicators in patients with complications were higher than those in patients without (P<0001). The LFI, LAR were positively correlated to leukocyte CD18 expression and sICAM1 concentration (r=0.413～0.812, P<0001), the LFI was positively correlated to the LAR (r=0.628, P<0001).Conclusion The decrease of LD and the increase of LAF, leukocyte CD18 expression and sICAM1 concentration might participate in the occurance of ACI.