急性CO中毒迟发性脑病患者血清sICAM-1、sE-selectin的检测及意义

Dynamic Changes of Soluble Intercellular Adhesion Molecule-l and Soluble E-selectin in Delayed Encephalopathy after Acute Carbon Monoxide Poisoning

目的动态观察急性一氧化碳中毒后迟发性脑病(DEACMP)血清中可溶性细胞间粘附分子(sICAM-1)和可溶性E-选择素(sE-selectin)的变化。方法用日常生活能力量表(ADL)、常识-记忆-注意测验(IMCT)、长谷川痴呆量表(HDS)检查30例DEACMP患者病情变化,同时应用(ELISA)法测定其血清sICAM-1、sE-selectin水平,并与28例急性一氧化碳中毒后未发生迟发性脑病患者和26例正常对照者进行比较。结果 DEACMP患者治疗前血清sICAM-1和sE-selectin水平明显高于急性CO中毒组和正常对照组(P<0.05)。治疗后DEACMP患者血清sICAM-1和sE-selectin水平明显低于急性期(P<0.01),sICAM-1和sE-selectin浓度呈正相关(r=0.417,P<0.05)。结论 sICAM-1和sE-selectin参与了DEACMP的炎症反应过程,且与病情程度密切相关,可作为一氧化碳中毒患者病情的主要监测指标之一。

Objective To investigate the dynamic changes of so luble intercellular adhesion molecule-1 （slCAM-1） and soluble E-selectin （sE-selectin） in delayed encephalopathy after acute carbon monoxide poisoning（DEACMP）. Methods By using enzyme-hnked immunno-sorbent assay（ELISA）,we detected the serum sICAM-1 and sE-selectin levels in DEACMP and observed the changes of three scales [the activity of daily living scale （ADL）,the information-memory-concentration test（IMCT） and the Hasegawa＇s dementia scale （HDS）] at the initial and convalescent stages to reflect the severity of the disease. Then these levels were compared with those of 26 normal control cases and with 28 cases of acute carbon monoxide poisoning with no DEACMP. Results The serum sICAM-1 and sE-selectin levels in DEACMP at the initial stage were significantly higher than those in the other two groups （P〈0.05）. At the convalescent stage, the serum slCAM-land sE-selectin levels in DEACMP were significantly lower than those at the initial stage（P〈0.01 ）. There was a significant correlation between the sICAM-1 level and sE-selectin level in DEACMP （P〈0.05）. Conclusion sICAM-1 and sE-selectin are involved in the inflammatory reaction in DEACMP, and closely related to the disease, and both can be used as one of the main monitoring indicators in carbon monoxide poisoning.