缺血性脑卒中血清可溶性细胞间粘附分子-1的含量变化

Serum levels of soluble intercellular adhesion molecule-1 in patients with cerebral infarct

目的 :观察脑梗死患者血清可溶性细胞间粘附分 - 1(s ICAM- 1)的含量变化 ,探讨其在脑梗死中的作用和意义。方法 :采用酶联免疫吸附法检测了 5 5例脑梗死患者急性期和恢复期血清 s ICAM- 1含量变化 ,并与 32例非脑梗死疾病患者和 30例正常健康者血清 s ICAM- 1含量比较。结果 :1脑梗死患者无论急性期还是恢复期其血清s ICAM- 1含量 [分别为 (766± 179) μg/ L和 (60 2± 15 5 ) μg/ L]均较两对照组 [分别为 (5 30± 77) μg/ L和 (5 2 1± 116)μg/ L]明显升高 (P<0 .0 1) ;2脑梗死急性期血清 s ICAM- 1含量与外周血中白细胞数量呈正相关 (r=0 .2 85 ,P<0 .0 5 ) ,与神经功能缺失评分呈负相关 (r=- 0 .333,P<0 .0 5 ) ;3脑皮质梗死组与基底节区梗死组间血清 s ICAM- 1含量差异无显著性 (P>0 .0 5 ) ,分别为 (773± 178) μg/ L和 (75 8± 183) μg/ L;4脑梗死伴有高血压组与不伴高血压组间血清 s ICAM- 1含量差异亦无显著性 (P>0 .0 5 ) ,分别为 (774± 189) μg/ L和 (75 4± 165 ) μg/ L。结论 :ICAM- 1通过炎症性白细胞变化机制参与了脑梗死的整个病理生理过程 ;急性期时测定血清 s ICAM- 1含量可以作为判断脑梗死发作的一个指标 ;脑梗死时血清 s ICAM- 1的浓度变化与病灶部位和有无高血压关系不?

Objective: To observe the changes of the levels of soluble intercellular adhesion molecule-1(sICAM-1) in serum of patients with cerebral infarct and to explore the effect of sICAM-1 on cerebral infarct. Methods: The serum levels of sICAM-1 in 55 patients with cerebral infarct both in acute stage(within 2 days) and convalescence(2 weeks after attack) were detected by using ELISA.At the same time, we compare the results with those of 32 patients having other neurologic diseases(20 patients with sciatica, 12 with trigeminal neuralgia) and 30 healthy subjects.Results:①The serum levels of sICAM-1 of patients with cerebral infarct (acute stage:766±179 μg/L, convalelescence: 602±155 μg/L, respectively) were significantly higher than those of the control groups(530±77 μg/L and 521±116 μg/L, respectively, P<0.01). ②There was a postive correlation of SICAM levels with the amount of leukocytes in acute stage(r=0.285,P<0.05), but negative correlation to clinical severity of cerebral infarct(r=-0.333,P<0.05).And there was no significant correlation between the level of sICAM-1 and the levels of cholesterol and triglyceride in serum(r=-0.042 and r=0.061, respectively,P>0.05). ③There was no significant difference between sICAM levels of patients of cerebral cortex infarct and those of patients with basal ganglia infarct(773±178 μg/L and 758±183 μg/L, respectively,P>0.05). ④The levels of sICAM-1 between patients of cerebral infarct with or without hypertension were no significant difference(774±189 μg/L and 754±165 μg/L, respectively, P>0.05).Conclusion: The levels of sICAM-1 increase significantly in patients with cerebral infarct.sICAM-1 may participate in the pathophysiologic process through inflammatory mechanism.