充血性心力衰竭病人血清VCAM-1和ICAM-1含量的变化及临床意义

CLINICAL SIGNIFICANCE OF SERUM VCAM-1 AND ICAM-1 IN CONGESTIVE HEART FAILURE

目的 :观察充血性心力衰竭 (CHF)病人血清血管细胞粘附分子 1 (VCAM 1 )、细胞间粘附分子 1 (ICAM 1 )浓度变化。方法 :应用酶联免疫吸附分析法测定 5 6例充血性心力衰竭病人和 2 5名健康对照者血清VCAM 1及ICAM 1。结果 :病人血清ICAM 1浓度为 (35 5± 4 5 )ng/ml,健康对照组血清ICAM 1浓度为(2 2 0± 36 )ng/ml(P <0 0 5 )。CHF病人血清VCAM 1浓度为 (6 5 5± 75 )ng/ml,健康对照组血清VCAM 1浓度为 (4 2 0± 4 6 )ng/ml(P <0 0 5 )。心功能Ⅳ级病人血清VCAM 1浓度为 (75 5± 78)ng/ml,高于心功能Ⅱ级、Ⅲ级病人血清VCAM 1浓度 (6 1 2± 4 7)ng/ml(P <0 0 5 )。冠心病CHF病人血清ICAM 1与VCAM 1浓度分别为 (375± 4 7)ng/ml和 (6 5 0± 6 5 )ng/ml,扩张性心肌病CHF病人血清ICAM 1与VCAM 1浓度分别为 (375± 4 7)ng/ml和 (6 6 5± 5 5 )ng/ml,两组相比P >0 0 5。结论 :CHF病人血清VCAM 1及ICAM 1浓度升高 ,而且VCAM 1浓度和心力衰竭的程度呈正相关 ;VCAM 1及ICAM 1浓度升高和心力衰竭病因无关 ,提示炎症有可能是充血性心力衰竭发病机制之一。

Objective:To determine vascular cell adhesion molecule 1(VCAM 1) and intercellular adhesion molecule 1 (ICAM 1) in the serum of patients with congestive heart failure.Methods:Serum VCAM 1 and ICAM 1 were assayed with enzyme linked immunosorbent assay in patients with congestive heart failure (CHF)and in healthy control subjects.Results:Serum ICAM 1 and VCAM 1 levels were higher in patients with CHF (355±45 ng/ml,655±75 ng/ml) than in healthy control subjects (220±36 ng/ml,420±46 ng/ml, P <0 05).Serum VCAM 1 level was higher (755±78 ng/ml)in patients with heart function class Ⅳ than in patients with heart function classes Ⅱ and Ⅲ (612±47 ng/ml, P <0 05)?Serum ICAM 1 and VCAM 1 levels in patients with ischemic heart diseases were 345±47 ng/ml and 650±65 ng/ ml ,respectively.Serum ICAM 1 and VCAM 1 levels in patients with dilated cardiomyopathy were 375±47 ng/ml and 665±55 ng/ml,respectively( P >0 05).Conclusions:Serum VCAM 1 and ICAM 1 increase in patients with CHF.VCAM 1 level correlates with the severity of CHF.The levels of VCAM 1 and ICAM 1 are unrelated to the pathogeny of CHF.Inflammation may be one of the mechanisms in the development of CHF.