蛛网膜下腔出血后脑脊液中粘附分子检测的意义

The Significance of Cerebrospinal Fluid Adhesive Molecule Test to Patients with Subarachnoid Hemorrhage

目的：分析蛛网膜下腔出血后脑脊液中可溶性粘附分子与颅内血管痉挛的关系。方法：原发性蛛网膜下腔出血患者19人，正常对照组18人，用ELISA法检测脑脊液中内皮细胞选择凝集素（E-Selectin），细胞间粘附分子一1（ICAM-1），血管细胞粘附分子一1（VCAM-1）和白细胞选择凝集素（L-Selectin）的含量，用TCD探测大脑前、中、后动脉的血流速度。结果：蛛网膜下胜出血后E-Selectin、ICAM-1、VCAM-1均明显升高（P＜005），颅内动脉血流速度普遍增快，脑脊液中粘附分子水平升高与颅内血管痉挛密切相关（r＝0.67）。结论：蛛网膜下腔出血后脑脊液中可溶性粘附分子水平升高与颅内动脉痉挛的发生密切相关。

Objective:To study the relation of soluble adhesion molecules in the cerebrospinal fluid (CSF) of Patients with subarahnoid hemorrhage (SAH) to the development of cerebral vasospasm. Methods: A contrastive analysis was performed on CSF samples obtained in 19 patients who had suffered SAH and in 18 normal adults by using quantitative enzyme - linked immunosorbent assays for E-selectin, ICAM -1, VCAM - land L -selectin. The veloeity of the blood flow in anterior, middle, and posterior cerebral artery was detected by thedrial doppler. Results: Levels of soluble forms of E-selectin'ICAM - 1 and VCAM - 1 were found to be elevated in the CSF of patients after SAH, compared with the nonnal controls (P < O. O1 ). The velocity of the cerebral blood flow was increased in patients after SAH. The development of cerebral vasospasm was closely related to the expression of the adhesion moecules in the CSF of patients after SAH(r=0.67) . Conclusion:The elevation of the soluble adhesion molecules in the CSF of patients after SAN is closely related to cerebral vasospasm.