冠心病人血浆可溶性细胞粘附分子和白细胞CD18表达的动态变化

The Diurnal Variation of Plasma Soluble Cell Adhesive Molecule and Leukocyte CD18 Expression in Patients with Coronary Heart Disease

目的探讨细胞粘附分子(CAMs)动态变化与冠心病发病的关系。方法采用酶联免疫吸附法(ELISA) ,检测90例冠心病人外周血白细胞CD18表达、血浆可溶性细胞间粘附分子 -1(sICAM -1)和可溶性血管细胞间粘附分子 -1(sVCAM -1)浓度的动态变化。结果冠心病人白细胞CD18表达、sICAM -1和sVCAM -1浓度均明显增高 ,与对照组比较有极显著差异性(t=7.692～11.458,P<0.001) ,且早晨各指标的增高均较下午更明显(t=3.052～12.460,P<0.01 ,0.001)。UA、AMI、OMI病人早晨各指标增高均较下午明显 ,且不同时间各指标间的比较差异亦具有显著性(F=5.826～10.945,q=6.788～9.625,P<0.01) ,以AMI病人各指标增高最明显。冠心病人早晨、下午白细胞CD18表达与sICAM -1和sVCAM -1浓度呈正相关(r=0.648～0.727,P<0.001)。结论冠心病发病早晨高发现象与白细胞CD18表达、sICAM -1和sVCAM -1浓度动态变化有密切关系。

Objective To explore the correlation between the diurnal variation of cell adhesive molecules(CAMs)and the attack of coronary heart disease (CHD). Methods By using enzyme_linked immunosorbern assay (ELISA),the diurnel variation of leukocyte CD18 expression in peripheral blood and Plasma soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cellular adhesion molecule-1(sVCAM-1) concentration were measured in 90 patients with CHD and 42 healthy subjects. Result The leukocyte CD18 expression, sICAM-1 and sVCAM-1 concentration were significanty higher in patients than those in controls (t=7.692～11.458,P<0.001),and they were higher in the morning than those in the afternoon (t=3.052～12.460,P<0.01,0.001),the variation in acute myocardial infarction (AMI) was more obvious than that in unstable angina (UA) and old myocardial infarction (OMI),and there were significant differences of different indicators in different time among UA, AMI and OMI(F=5.826～10.945,q=6.788～9.625,P<0.01). The leukocyte CD18 expression was positively correlated to the sICAM-1 and sVCAM-1 concentration in patients in the morning and afternoon(r=0.648～0.727,P<0.001). Conclusion The phenomenon of the frequent occurence of attack of CHD in the morning might be related to the diurnal variation of leukocyte CD18 expression, sICAM-1 and sVCAM-1 concentration.