急性脑出血病人血清sICAM-1、MDA变化的临床研究

Changes of Serum sICAM-1 and MDA in Patients with Acute Intracerebral Hemorrhage

目的 探讨急性脑出血病人血清可溶性细胞间黏附分子(sICAM -1)和丙二醛 (MDA)含量变化及临床意义。方法 采用双抗体夹心酶联免疫吸附(ELISA )法、硫代巴比妥酸(TBA)法分别测定 80例急性脑出血病人和 2 0例健康人血清中sICAM -1、MDA的含量。结果 与正常对照组相比 ,急性脑出血病人血清sICAM -1、MDA含量明显升高 (P <0 .0 1) ,sICAM -1、MDA在轻、中、重型组之间比较有统计学意义 (P <0 .0 5 ,P <0 .0 1) ;72h内不同发病时间各组sICAM -1、MDA均有统计学意义 (P <0 .0 1) ;以 2 5h～ 48h组为最高 ;急性脑出血病人血清sICAM -1、MDA两指标之间呈高度的正相关。结论 急性脑出血白细胞黏附、机体氧化应激增强 ,病人血清sICAM -1、MDA明显升高 ,二者关系密切 ,参与了脑出血后脑损伤的病理过程 ;急性脑出血sICAM -1、MDA水平的高峰期在 2 5h～ 48h ;且随着神经功能缺损的严重程度、病灶体积增加而增高 ,可作为判定病情严重程度的参考指标。

Objective To investigate the changes and significance of serum soluble intercellular adhesion molecule-1 (sICAM-1) and Malondialdehyde (MDA) in patients with acute intracerebral hemorrhage (AICH). Methods The serum concentrations of sICAM-1 and MDA in 80 patients with AICH and 20 of healthy controls were measured respectively by two-layer antibody sandwich enzyme-linked immunosorbent assay (ELISA) and thiobarbituric acid (TBA) methods. Results Compared with the control group, the serum concentrations of sICAM-1, MDA in patients with AICH increased significantly (P<0.01); Between any two of the three disease groups there was obvious difference in the concentrations of the two indexes (P<0.05,P<0.01); During 72 h after onset, the levels of the indexes in the different time groups were higher than those in the control group, the highest was in 25 h～48 h group; The remarkable difference of the indexes was found in large and small volume groups(P<0.05, P<0.01); There was close positive correlation between serum sICAM-1 and MDA in patients of AICH. Conclusion The leukocyte adhesion and oxidative stress increased in patients with AICH, the levels of serum sICAM-1 and MDA increased remarkably.Two of them had close relation,and were involved in the pathological mechanism of cerebral damage after ICH; The peak time of the two indexes was in 25 h～48 h; The levels of the two indexes changed with the increase of the degree of the nervous function impairment, the volume of the foci; The serum sICAM-1 and MDA might be the important parameters for clinical evaluation of severity in AICH.