血栓调节蛋白和血管细胞黏附分子-1在缺血性脑卒中患者外周血中的表达

The Expression and Clinical Significance of Thrombomodulin and Vascular Cell Adhesion Molecule-1 in Patients with Ischemic Stroke

目的:探究缺血性脑卒中患者外周血中血栓调节蛋白(TM)和血管细胞黏附分子-1(VCAM-1)的表达水平,及其与患者神经功能缺损(NIHSS)评分的关系。方法:选取86例新发缺血性脑卒中患者作为观察组,40例体检者作为对照组,检测两组人群入院2 h、入院后第1、3、7、14天时外周血中TM和VCAM-1的水平或体检时所取血液标本中TM和VCAM-1的水平;观察组根据NIHSS评分再分为进展组和恢复组,比较两组患者TM和VCAM-1水平,采用Spearman对观察组患者入院第7天时的TM和VCAM-1水平及NIHSS评分进行相关性分析。结果:入院2 h,观察组患者外周血TM和VCAM-1水平明显高于对照组,差异有统计学意义(P<0.01);入院第1、3天,进展组和恢复组外周血TM和VCAM-1水平比较,差异无统计学意义(P>0.05);入院第7、14天,进展组外周血TM和VCAM-1水平显著高于恢复组,差异有统计学意义(P<0.05);入院第7天,观察组患者外周血TM和VCAM-1水平与NIHSS评分存在正相关性(P<0.05)。结论:缺血性脑卒中患者外周血TM、VCAM-1水平与疾病的进展密切相关。

Objective： To explore the expression of thrombomodulin（ TM） and vascular cell adhesion molecule-1（ VCAM-1） in peripheral blood of patients with ischemic stroke,and explore the relationship between the expressions of TM,VCAM-1 and the National Institutes of Health Stroke Scale（ NIHSS）. Methods： The 86 case of patients with new ischemic stroke were selected as observation group,and blood samples of 40 cases of normal people from medical examination center were selected as control group. The expression levels of TM and VCAM-1 in the peripheral blood of the two groups were detected after admission 2 h and first,third,7^th or 14^th days. Comparing the expression levels of TM and VCAM-1 in two groups,and the NIHSS score was evaluated. According to NIHSS score,observation group were divided into progressive group and recovery group. Spearman correlation analysis was used to analyze the correlation between the expression levels of TM and VCAM-1 and the changes of NIHSS score in 7^th days. Results： After admission for 2 h,the TM and VCAM-1 levels of observation group was significantly higher than those of control group,and the difference was statistically significant（ P〈0. 01）. The difference of TM and VCAM-1 level in peripheral blood of the patients in the progressive group and recovery group at 1^st and 3^rd day after admission was not statistically significant（ P〉0. 05）.The TM and VCAM-1 levels in the progressive group were significantly higher than those in the recovery group at 7^th and 14th day after admission,the difference was statistically significant（ P〈0. 05）.Spearman correlation analysis showed that TM and VCAM-1 levels were positively correlated with the changes of NIHSS score in 7^th day. Conclusion： TM and VCAM-1 are closely related to the occurrence and development of ischemic stroke.