急性脑梗死合并2型糖尿病患者血清ALCAM、PECAM-1水平与颈动脉斑块稳定性的关系

Relationship of Carotid Plaque Stability with Serum ALCAM and PECAM-1 in Patients with Acute Cerebral Infarction and Type 2 Diabetes Mellitus

【目的】探讨急性脑梗死合并2型糖尿病患者血清活化白细胞黏附分子(ALCAM)、血小板内皮细胞黏附分子-1(PECAM-1)水平与颈动脉斑块稳定性的关系。【方法】选择在两院住院确诊的急性脑梗死合并2型糖尿病患者80例(观察组),另选取同期本院住院确诊的65例不伴2型糖尿病的急性脑梗死患者(对照组)。比较两组患者ALCAM、PECAM-1的水平,观察急性脑梗死合并2型糖尿病患者ALCAM、PECAM-1与颈动脉斑块稳定性和内部血管形成分级的关系。采用Pearson相关分析法分析ALCAM、PECAM-1与急性脑梗死合并2型糖尿病患者美国国立卫生院卒中量表(NIHSS)评分的关系。【结果】观察组ALCAM、PECAM-1水平均高于对照组(P<0.05)。观察组80例患者中无斑块11例,稳定斑块24例,不稳定斑块45例;无斑块患者ALCAM、PECAM-1水平低于稳定斑块患者和不稳定斑块患者(P<0.05),稳定斑块患者ALCAM、PECAM-1水平低于不稳定斑块患者(P<0.05)。80例患者中颈动脉斑块内部血管形成分级为0~1级的患者39例,2~3级患者41例,其中0~1级患者ALCAM、PECAM-1水平低于2~3级患者(P<0.05)。急性脑梗死合并2型糖尿病患者ALCAM、PECAM-1水平与NIHSS评分均呈正相关(均P<0.05)。【结论】ALCAM、PECAM-1在急性脑梗死合并2型糖尿病患者血清中的表达水平明显升高,其不仅与颈动脉斑块的稳定性、内部血管形成分级密切相关,还与患者神经功能受损程度呈显著正相关,临床应引起重视。

【Objective】To investigate the relationship of carotid plaque stability with serum levels of activated leukocyte cell adhesion molecule(ALCAM)and platelet endothelial cell adhesion molecule-1(PECAM-1)in patients with acute cerebral infarction complicated with type 2 diabetes mellitus.【Methods】A total of 80 patients with acute cerebral infarction complicated with type 2 diabetes diagnosed in our hospital were selected as the observation group,while 65 acute cerebral infarction patients without type 2 diabetes in our hospital in the same period were selected as the control group.The levels of ALCAM and PECAM-1 were detected and compared between the two groups,and the relationship of carotid plaque stability and internal vessel formation grade with ALCAM and PECAM-1 in patients with acute cerebral infarction complicated with type 2 diabetes mellitus was analyzed.Pearson correlation analysis was used to analyze the relationship among ALCAM,PECAM-1 and NIHSS score in patients with acute cerebral infarction complicated with type 2 diabetes mellitus.【Results】The levels of ALCAM and PECAM-1 in the observation group were higher than those in the control group(all P<0.05).In the observation group,there were 11 cases without plaque,24 cases with stable plaque and 45 cases with unstable plaque.The levels of ALCAM and PECAM-1 in patients without plaque were lower than those in patients with stable plaque and unstable plaque(all P<0.05),and the levels of ALCAM and PECAM-1 in patients with stable plaque were lower than those in patients with unstable plaque(all P<0.05).Among the 80 patients,39 patients had carotid plaque internal vascularization grade of 0~1 and 41 patients had grade 2~3.The levels of ALCAM and PECAM-1 in grade 0~1 patients were lower than those in grade 2~3 patients(all P<0.05).The levels of ALCAM and PECAM-1 were positively correlated with NIHSS score in patients with acute cerebral infarction complicated with type 2 diabetes mellitus(all P<0.05).【Conclusion】Serum levels of ALCAM and PECAM-1 in patients with acute cerebral infarction complicated with type 2 diabetes mellitus are significantly increased,which are not only closely related to the stability of carotid plaque and internal vascular formation grade,but also significantly positively related to the degree of neurological impairment.Thus,in clinical practice the relationship should be paid attention to.