脑梗死患者白细胞流变特性及分子流变特性研究

The Study of Leukocyte and Molecule Rheology in Patients with Cerebral Infarction

目的 探讨脑梗死患者白细胞流变特性和分子流变特性改变及其在脑缺血性损伤中的作用。方法 对62例急性脑梗死患者及 3 8名健康对照者外周血白细胞聚集性 (LA)、白细胞黏附功能 (LAF)和血清可溶性细胞间黏附分子 -1 (s ICAM-1 )、血管内皮细胞黏附分子 -1 (s VCAM-1 )浓度进行检测 ,根据头部 CT结果将脑梗死分成大面积脑梗死和中小面积脑梗死 ,同时对脑梗死患者神经功能缺损程度进行评分。结果 急性脑梗死患者LA、LAF和 s ICAM-1、s VCAM-1的浓度明显增高 ,与对照组比较差异有显著性 (P<0 .0 5 ) ;大面积脑梗死患者LA、LAF和 s ICAM-1、s VCAM-1的浓度均较中小面积脑梗死患者明显增高 ,差异有显著性 (P<0 .0 5 ) ;脑梗死患者神经功能缺损程度评分与 LA、LAF和 s ICAM-1、s VCAM-1呈正相关 (r=0 .3 3 77～ 0 .71 88,P<0 .0 5 ) ;LA和 LAF均与 s ICAM-1、s VCAM-1呈正相关 (r=0 .3 3 3 1～ 0 .5 865 ,P<0 .0 5 )。结论 急性脑梗死患者存在白细胞流变特性及分子流变特性的异常 ,这种异常在脑缺血和再灌注损伤中可能发挥重要作用。

Objective To investigate the change of leukocyte and molecule rheology and their role in cerebral ischemic/reperfusion injury in patients with cerebral infarction.Methods The leukocyte aggregation(LA)and leukocyte adhesion function(LAF),as well as serum soluble intercellular adhesion molecule 1(sICAM 1)and vascular cell adhesion molecule 1((sVCAM 1)concentration were mearsured in 62 patients with cerebral infarction and 38 healthy controls.According to the CT scans,the patients with cerebral infarction were divided into as large area and medial or small area infarction.The neurological deficits in patients with cerebral infarction were evaluated.Results The LA,LAF,sICAM 1 and sVCAM 1 concentrations were significantly higher in patients with acute cerebral infarction than those in controls(P<0 05).The LA,LAF,sICAM 1 and sVCAM 1 concentrations were significantly higher in patients with large area infarction than those in patients with medial or small area infarctions(P<0 05).The neurological deficit scores were positively correlated to LA,LAF,sICAM 1 and sVCAM 1 concentration(r=0 3377 0 7188,P<0 05),While the LA,LAF were positively correlated to sICAM 1 and sVCAM 1 concentration(r=0 3331 0 5865,P<0 05).Conclusions There areabnormalities of leuckocyte rheology and molecule rheology in patients with cerebral infarction,these abnormalities may play a key role in cerebral ischemic/reperfusion injury.