早期脑卒中患者外周血细胞粘附因子和转化生长因子变化的意义及高压氧干预的影响

The changes of intercellular adhesion molecule-1 and transforming growth factor in peripheral blood cells of the patients with prophase stroke after the intervention of hyperbaric oxygen

目的探讨早期脑卒中患者外周血细胞粘附因子-1(s ICAM-1)和转化生长因子-β_1(TGF-β_1)变化的意义及高压氧干预后二者的变化情况。方法采用酶联免疫吸附法(ELISA)测定42例急性脑卒中患者和42名健康人的血清s ICAM-1和TGF-β_1浓度。在42例患者中随机选定21例在常规治疗基础上加用高压氧治疗1周。结果早期脑卒中组发病后第1、2、3天血清s ICAM-1浓度显著高于健康对照组(P均<0.01),早期脑卒中组于发病后第1、2、3天的血清TGF-β_1浓度与健康对照组比较差异无统计学意义(P>0.05)。高压氧干预第3、7、10天患者血清s ICAM-1浓度较未干预组降低(P<0.01),而血清TGF-β_1浓度较未干预组升高(P<0.01)。结论血清s ICAM-1和TGF-β_1浓度动态变化反映早期脑卒中患者炎症和免疫状态,且s ICAM-1具有损伤作用,TGF-β_1具有保护作用。高压氧的干预有抗炎和促进组织修复作用。

Objective To investigate the changes of intercellular adhesion molecule-1 （ sICAM-1 ） and transforming growth factor（TGF-β1 ） in peripheral blood cells of the patients with prophase stroke after the intervention of hyperbaric oxygen. Methods The concentrations of sICAM-1 and TGF-β1 were measured by enzyme-linked immunosorbent assay（ELISA） in 42 patients with acute stroke and in 42 healthy people. Based on the conventional treatment, 21 patients were randomly selected from the 42 patients with acute stroke and were treated with hyperbaric oxygen for a week. Results The concentrations of sICAM-1 in the stroke patients were significantly higher than those in the healthy people（P 〈 0. 01 ） 1, 2 and 3 days after stroke, while the concentrations of TGF-β1 in the stroke patients were significantly lower than those in the control group on the first day and the third day of the stroke. Compared with those in the stroke patient with no intervention of hyperbaric oxygen, the concentrations of sICAM-1 in the patients with the intervention of hyperbaric oxygen were significantly reduced （ P 〈 0.01 ） and the concentrations of TGF-β1 were significantly increased（P 〈0. 01 ） 3, 7 and 10 days after the intervention of hyperbaric oxygen. Conclusion The dynamic changes of sICAM-1 and TGF-β1 reflect the inflammation and immune status in the patient with prophase stroke, sICAM-1 is the risk factor while TGF-β1 has a protective effect. The intervention of hyperbaric oxygen plays a role of anti-inflammatory and promoting tissue repair.