急性大血管闭塞性脑卒中桥接治疗后再灌注损伤sCD40L、ET-1、ICAM-1因子相关性研究

Correlation between sCD40L,ET-1 and ICAM-1 and reperfusion injury after bridge therapy in patients with acute large vessel occlusive stroke

目的探讨血清细胞间黏附分子(ICAM-1)、内皮素-1(ET-1)、血浆可溶性CD40配体(sCD40L)与急性大血管闭塞性脑卒中桥接治疗后再灌注损伤的关系。方法选取湖南省脑科医院2021年12月至2022年12月间接受桥接治疗的急性大血管闭塞性脑卒中患者90例。按照术后是否出现再灌注损伤并发症进行分组,分为再灌注损伤组和未再灌注损伤组:运用ELISA法检测桥接治疗前和治疗开始后30 min、1h、2h、6h、24 h、5d的患者血清sCD40L、ICAM-1、ET-1的水平,并分析两组之间的差异以及治疗前后这3种因子水平的变化。结果治疗前再灌注损伤组和未再灌注损伤组患者血清中sCD40L、ICAM-1、ET-1水平比较差异无统计学意义(P>0.05)。未再灌注损伤组患者的治疗前及治疗后30 min、1 h、2h、6h、24 h、5d的血清中sCD40L、ICAM-1、ET-1水平随时间推移的变化急性大血管闭塞性脑卒中桥接治疗后再灌注损伤组患者的血清sCD40L、ICAM-1、ET-1水平增高,并且随时间推移逐渐升高。均不显著(P>0.05),各指标间无差异:再灌注损伤组患者治疗后各时间点血清中sCD40L、ICAM-1、ET-1水平均显著高于治疗前(均P<0.05),且在治疗后30 min、1h、2h、6 h、24 h、5d的时间点,患者血清中sCD40L、ICAM-1、ET-1水平均随时间变化而升高,不同时间亚组间比较差异均有统计学意义(~均P<0.05)。再灌注损伤组患者治疗后各时间点血清中sCD40L、ICAM-1、ET-1水平均高于未再灌注损伤组相同时间点(~均P<0.05)。结论急性大血管闭塞性脑卒中桥接治疗后再灌注损伤组患者的血清sCD40L、ICAM-1、ET-1水平增高,并且5d内随时间推移逐渐升高。

Objective The aim of this study was to explore the relationship between ICAM-1 and endothelin-1(ET-1)in serum.plasma soluble CD40 ligand(sCD40L)and reperfusion injury after bridge therapy in acute great vascular occlusive stroke.Methods A total of 90 patients with acute great vascular occlusive stroke who received bridging therapy in Hunan Brain Hospital from December 2021 to December 2022 were retrospectively selected.The patients were divided into reperfusion injury group and non-reperfusion injury group according to whether there were complications of reperfusion injury after surgery.The serum levels of sCD40L,ICAM-1 and ET-1 were detected by ELISA before and 30 minutes,1 hour,2 hours,6 hours,24 hours and 5 days after the bridge treatment,and the differences between the two groups and the changes of the levels of these three factors before and after treatment were analyzed.Results There was no significant difference in senum levels of Scd40L-ICAM-1 and ET-1between the reperfusion injury group and the non-reperfusion injury group before treatment(P>0.05).There were no significant changes in serum levels of sCD40L,ICAM-1 and ET-1 before treatment and 30 minutes,1 hour,2 hours,6hours,24 hours and 5 days after treatment in patients with no reperfusion injury group as time went by(P>0.05).There was no differeance among the indicators.The levels of sCD40L,ICAM-1 and ET-1 in serum of reperfusion injury group were significantly higher than those before treatment at all time points after treatment(~(all)P<0.05).And at 30minutes,1 hour,2 hours,6 hours,24 hours and 5 days after treatment,the serum levels of sCD40L,ICAM-1 and ET-1were increased with time,and the differences among subgroups at different time were statistically significant(~(all)P<0.05).The serum levels of sCD40L,ICAM-1 and ET-1 in the reperfusion injury group were higher than those in the non-reperfusion injury group at all time points after treatment(~(all)P<0.05).Conclusion The serum levels of sCD40L,ICAM-1 and ET-1 in the group of patients with reperfusion injury after bridge therapy for acute great vascular occlusive stroke were increased,and gradually increased over time.