脑血管意外患者的选择素、组织因子、血液流变学的监测及意义

Significance of Selectin,Tissue factor and Hemorrhelogy in Stroke Cerebrovascular disease

目的 本文探讨高血压致脑血管意外患者的选择素P、L、E与组织因子及血液流变之间关系和临床意义。方法 选择素、组织因子测定用ELISA法 ,采用美国ADI公司提供试剂合。血液粘度测定采用北京中勤世帝公司制造R - 80锥板式血流变仪。结果 选择素P、L、E在急性脑梗死组 ,TIA组均明显升高 ,全血低切、组织因子也明显升高。 15例急性脑梗死组选择素P、L、E在第一天最高 ,以后逐渐下降 ,第二、四周差异不大 (P >0 0 5 ) ,组织因子在第二周才下降。血液粘度测定在所有患者中有 38%在正常范围内。选择素P、L、E的表达与组织因子表达呈正相关。结论 本组提示选择素P、L、E和组织因子表达在脑梗死和TIA组患者较血液粘度更为敏感 ,在脑缺血病变患者测定选择素和组织因子对疾病的诊断和了解病情严重程度有一定参考价值。

Objective Selectin P,L,E,tissue factor and hemorrhelogy in acute cerebral infarction and TIA have not been investigated in detail. This paper is aimed to study the alteration of these factors and to explore their significances. Methods Eighty five patients were enrolled and categorized into three groups: acute cerebral infarction ( n =35),TIA ( n =25) and old cerebral infarction( n =28). Selectin P,L,E and tissue factor (TF) were measured by enzyme linked immunosorbent assasy(ELISA). Results Selectin P,L,E and TF were significantly increased in acute cerebral infarction and TIA than that in control ( P <0.01,respectively). Dynamic observation showed that selectin P,L,E,were increased at the 1 st day after the onset of acute cerebral infarction,thenafter,their concentration were gradually decreased until the 4 th weeks. TF was sustained at high level until the 2 nd weeks. Selectin was positively correlated with TF. Blood viscosity was in normal range in 38% of all patient. Conclusion Selectin and TF measurement were more sensitive in detecting patients of acute cerebral infarction and TIA than that by blood viscosity,indicating they are playing important roles in the pathogenesis of cerebral vascular diseases.