急性心肌梗塞病人细胞粘附分子与补体激活成分的动态变化

Changes in cell adhesion molecules and composition of complement activation in patients with acute myocardial infarction

目的 :探讨急性心肌梗塞 (AMI)病人血浆细胞粘附分子和补体活化成分的变化。方法 :采用酶联免疫吸附法 (ELISA) ,检测了 67例AMI病人发病第 1、4、7d时和 3 8例健康人 ,4 2例陈旧性心肌梗塞 (OMI)病人白细胞CD18表达、血浆可溶性细胞间粘附分子 - 1(sICAM - 1)、可溶性血管细胞间粘附分子 - 1(sVCAM - 1)和血浆补体活化片段 (sC5b - 9)浓度的变化。结果 :AMI病人白细胞CD18表达、sICAM - 1、sVCAM - 1和sC5b - 9浓度非常显著高于对照组和OMI病人 (P <0 0 1)。发病第 1- 7d ,白细胞CD18表达、sICAM - 1、sVCAM - 1和sC5b - 9浓度逐渐降低。死亡者和伴有室性心律失常者各指标增高较存活者和无室性心律失常者更明显 (P <0 0 1)。AMI病人白细胞CD18表达、sICAM - 1、sVCAM - 1浓度与sC5b - 9浓度呈正相关 (r=0 648,0 65 2 ,0 668,0 698,0 914 ,0 72 5 ,0 73 7,0 75 2 ,0 792 ,P <0 0 1) ,白细胞CD18表达与sICAM - 1、sVCAM - 1浓度呈正相关 (r =0 662 ,0 683 ,0 695 ,0 73 8,0 74 4 ,0 74 5 ,P <0 0 1)。结论 :细胞粘附分子和补体激活成分的相互作用参与了AMI的发生和发展 ,且与病情严重程度和预后有密切关系。

AIM: To explore the possible changes in cell adhesion molecules and composition of complement activation in patients with acute myocardial infarction (AMI). METHODS: The expression of leukocyte CD18, soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular-cell adhesion molecule-1 (sVCAM-1) and composition of complement activation (sC5b-9) concentrations of patients with AMI (67 cases), old myocardial infarction (OMI, 42 cases) and 38 healthy volunteers were measured using enzyme-linked immunosorbent assay(ELISA). RESULTS: The expression of leukocyte CD18, sICAM-1,sVCAM -1 and sC5b-9 were significantly higher in AMI patients than that in normal controls and OMI patients(P<0.01). Interestingly, it was also found that the expression of leukocyte CD18, sICAM-1,sVCAM-1 and sC5b-9 concentrations were much higher in patients with ventricular arrhythemia (VA) and the died than that in patients without VA and survivals (P<0.01). Furthermore, the leukocyte CD18 expression, sICAM-1 and sVCAM-1 were positively correlated to sC5b-9 in AMI patients (r=0.648,0.652,0.668,0.698,0.914,0.725,0.737,0.752,0.792,P<0.01), and leukocyte CD18 expression was positively correlated to sICAM-1 and sVCAM-1(r=0.662,0.683,0.695,0.738,0.744,0.745, P<0.01).CONCLUSION:The interaction of cell adhesion molecules and composition of complement activation might participate in the occurance and development of AMI,and closely related to the seriousness of patients'condition and prognosis.