急性心肌梗死血浆可溶性黏附分子水平改变的临床意义

The clinic value of the changes of soluble cell adhesion molecules in patients with acute myocardial infarction

目的 检测急性心肌梗死 (AMI)患者血浆可溶性细胞间黏附分子 - 1(sICAM - 1)、血管细胞间黏附分子 - 1(sVCAM - 1)及E -选择素 (sE -selectin)水平的变化 ,并探讨其临床意义。方法 用ELISA法检测 4 8例AMI患者血浆sICAM - 1、sVCAM - 1、sE -selectin的水平 ,并以 2 2例稳定性心绞痛 (SAP)患者及 2 0例健康体检者为对照。结果 AMI组与健康组相比较 ,三种可溶性黏附分子水平均增高 ,差异非常显著 (P <0 .0 1) ;与SAP组相比较 ,sICAM - 1在两组间无显著性差异 (P >0 .0 5 ) ,而sVCAM - 1及sE -selectin在两组间差异显著 (P <0 .0 5 ,P <0 .0 1)。AMI按LVEF >0 .4 0和LVEF≤ 0 .4 0值分组比较 ,sICAM - 1、sVCAM - 1、sE -selectin在两组间均有显著性差异 ,偏相关分析显示 ,三种可溶性黏附分子水平与心功能严重程度呈正相关 ,相关系数依次为sV CAM - 1(r=0 .4 8,P <0 .0 1)、sE -selectin(r =0 .4 4 ,P <0 .0 1)、sICAM - 1(r =0 .32 ,P <0 .0 1)。结论 AMI患者sICAM - 1、sVCAM - 1、sE -selectin水平增高 。

Objectives To value the changes of cell adhesion molecules in patients with acute myocardial infarction.Methods The level of plasma soluble intercellular adhesion molecule-1(sICAM-1), vascular cell adhesion molecule-1(sVCAM-1) and sE-selectin of 48 cases with acute myocardial infarction(AMI) were detected respectively by means of Enzyme-Linked Immunosorbent Assay(ELISA) and 22 cases with stable angina pectors(SAP) and 20 healthy persons acted as control groups.Results The level of sICAM-1, sVCAM-1 and sE-selectin with AMI were significantly higher than that of healthy group (P<0.01).There were also found significant differences in the levels of sVCAM-1(P<0.05) and sE-selectin(P<0.01) between the AMI group and the SAP group while the level of sICAM-1 not(P>0.05).When patients with AMI classified by LVEF>0.40 and LVEF≤0.40, the level of all there type soluble cell adhesion molecules were higher in group with LVEF≤0.40 than that with LVEF>0.40, and a significant correlation between the severity of heart failure and the level of sVCAM-1(r=0.48,P<0.01)?sE-selectin(r=0.44,P<0.01)?sICAM-1(r=0.32,P<0.01).Conclusions The level of sICAM-1, sVCAM-1 and sE-selectin increased and related to heart founction in patients with AMI and might be indexes for severity of AMI.