小动脉闭塞性脑卒中与血清细胞间黏附分子1和内皮素1的相关性研究

Relation of cerebral stroke due to small artery occlusion with serum intercellular adhesion molecule 1 and endothelin 1

目的探讨小动脉闭塞性脑卒中(small vessel disease,SAO)与血清细胞间黏附分子l(intercellular adhesionmolecule-1,ICAM-1))、内皮素1(endothelin-1,ET-1)的关系及临床意义。方法选择首次急性SAO患者160例(SAO组),根据影像学检查有无白质疏松分为单纯腔隙性脑梗死组(ILI组75例)和缺血性白质疏松组(ILA组85例)。另选择健康体检者80例作为对照组。比较SAO组与对照组血清ICAM-1、ET-1水平,并进一步比较ILI组与ILA组的差异。结果 SAO组血清ICAM-1、ET-1明显高于对照组,差异有统计学意义[(323.55±44.04)ng/Lvs(275.34±37.03)ng/L,(74.12±13.20)ng/L vs(59.94±14.69)ng/L,P<0.01]。与ILI组比较,ILA组年龄偏大,ICAM 1、ET-1水平及高血压发生率明显增高,高胆固醇血症发生率明显降低,差异有统计学意义(P<0.05,P<0.01)。结论 ICAM-1、ET-1与SAO显著相关,尤其与ILA关系更为密切。ILA及ILI代表了2种不同类型的SAO。

Objective To study the relation of cerebral stroke due to small artery occlusion（SAO） with serum intercellular adhesion molecule 1 （ICAM-1） and endothelin 1 （ET-1） and its clinical significance. Methods One hundred and sixty patients with acute cerebral stroke due to SAO,enrolled as a SAO group in this study,were divided into isolated lacunar infarction（ILI）group（n= 75） and ischemic leukoaraiosis （ILA） group （n = 85） depending on their imaging. Eighty healthy individuals undergoing physical examination served as a control group. Serum ICAM-1 and ET-1 levels were measured in SAO group,control group,ILI group and ILA group. Results The serum ICAM-1 and ET-1 levels were significantly higher in SAO group than in control group（323.55±44.04 ng/L vs 275.34±37.03 ng/L,74.12±13. 20 ng/L vs 59.94±14.69 ng/L,P〈0.01）. The age, serum ICAM-1 and ET-1 levels,and incidence of hypertension were significantly higher while the incidence of hypercholeslerolemia was significantly lower in ILA group than in ILI group （P〈 0. 05,P〈0. 01）. Conclusion Serum ICAM-1 and ET-1 levels are closely related with cerebral stroke due to SAO, especially with ILA. ILA and ILI represent two different kinds of cerebral stroke due to SAO.