脑梗死患者血清可溶性黏附分子的变化及临床意义

Changes of serum soluble adhesion molecules in patients with acute cerebral infarction and their clinical significance

目的 了解急性脑梗死患者血清可溶性黏附分子的变化及临床意义。 方法 采用双抗体夹心ELISA法测定了 77例脑梗死患者血清可溶性黏附分子 ,并与 36例脑出血和 30例健康人对照比较。 结果 脑梗死患者 2 4h内血清可溶性黏附分子水平〔sICAM 1:(4 80 3± 2 6 1) μg/L ,sVCAM 1:(1197± 81) μg/L ,sELAM 1:(5 0 4 4± 2 6 9) μg/L〕明显高于脑出血和健康对照组 (P <0 0 1) ,至第 14天仍高于脑出血组和健康对照组 ;大梗死灶组血清可溶性黏附分子水平〔sICAM 1:(5 0 81± 30 4 ) μg/L ,sVCAM 1:(12 2 3± 4 9) μg/L ,sELAM 1:(5 2 4 4± 2 89) μg/L)明显高于中梗死灶组和小梗死灶组。脑梗死后并发感染患者在 14d内血清可溶性黏附分子水平明显高于无并发感染者。 结论 可溶性黏附分子与急性脑梗死密切相关 ,可溶性黏附分子可作为脑梗死治疗时 ,特别是进展性卒中治疗的重要监测指标之一。

Objective To characterize the releasing pattern of soluble adhesion molecules in patients with acute cerebral infarction. Methods The levels of serum soluble adhesion molecules of 77 patients with acute cerebral infarction were serially measured with ELISA, and were compared with that of 36 patients with cerebral hemorrhage and 30 normal controls. Results The levels of serum soluble adhesion molecules in patients with cerebral infarction 24 hours after the onset 〔sICAM-1:(4 803±261) μg/L, sVCAM-1:(1 197±81) μg/L, sELAM-1:(5 044±269) μg/L 〕were higher than those in patients with cerebral hemorrhage and those in normal controls (P<0.01); they were still higher than that in patients with cerebral hemorrhage and normal controls at the l4th day after the onset. The levels of serum soluble adhesion molecules were significantly higher in the patients with large cerebral infarction 〔sICAM-1:(5 081±304) μg/L, sVCAM-1:(1 223±49) μg/L, sELAM-1:(5 244±289) μg/L〕 than in patients with medium and small cerebral infarctions (P<0.01). The levels of serum soluble adhesion molecules were higher in patients complicated with infection compared with those without. Conclusions These findings suggeste that soluble adhesion molecules are closely related to the development of acute cerebral infarction. Further study is needed on the change of serum soluble adhesion molecules during the treatment of cerebral infarction, especially of progressive stroke.