EFFECT OF REPERFUSION THERAPY ON SOLUBLE CELL ADHESION MOLECULES IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

Objective To observe the changes of serum soluble intercellular adhesion moiecuie type-1(ICAM-1) and E-selectin in patients with acute myocardial inlarction (AMI) receiving reperfusiontherapy. Methods Peripheral venous blood samples were taken from 21 patients with AMI before and4,8,12,24,48,72h after thrombolytic treatment or direct percutaneous transluminal coronary angioplasty (PTCA).Blood samples from 16 control subjects were drawn for one time. Serum concentration of ICAM-1 and E-selectinwas determined by double antibodies sandwich enzyme-linked immunosorbent assay. Results Serum levels ofICAM-1 and E-selectin were higher in patients with AMI than those in controls. Sixteen patients with AMIand successful roperfusion therapy had signifcantly reduction in serum concentration of ICAM-1 and E-selectinat 24 and 48h, but had a peak at 4h. The remaining live patients who failed in mperfusion theropy didn’t show anysignificant changes in these values. Conclusion The serum concentration of ICAM-1 and E-selectin waselevated significantly in patients with AMI Successful reperfusion therapy can reduce the increased serumconcentration.

再灌注治疗对急性心肌梗死患者可溶性细胞粘附分子的影响

目的：观察急性心肌梗死（ＡＭＩ）患者接受再灌注治疗后，血清可溶性血管细胞粘附分子－１（ＶＣＡＭ－１）和Ｅ－选择素（Ｅ－Ｓ）水平的动态变化。方法：ＡＭＩ组患者２１例，随机接受直接ＰＴＣＡ或溶栓治疗，于再灌注治疗前、及治疗后４、８、１２、２４、４８、７２小时各抽血一次。不稳定型心绞痛患者１６例，对照组１６例各抽血一次。用双抗体夹心ＥＬＩＳＡ法测定ＶＣＡＭ－１和Ｅ－Ｓ。结果：１．ＡＭＩ组和不稳定型心绞痛组ＶＣＡＭ－１测值分别为９３６．７±１９６．８ｎｇ／ｍｌ和８２８．１±１７３．６ｎｇ／ｍｌ，均显著高于对照组６１１．４±７４．６ｎｇ／ｍｌ（Ｐ＜０．０１），Ｅ－Ｓ测值分别为５６．０±８．８ｎｇ／ｍｌ和５８．７±９．５ｎｇ／ｍｌ，均显著高于对照组４４．９±６．２ｎｇ／ｍｌ（Ｐ＜０．０５）。２．ＡＭＩ组中１６例接受再灌注治疗成功患者ＶＣＡＭ－１于２４、７２小时显著降低（Ｐ＜０．０５），Ｅ－Ｓ于２４、４８小时显著降低（Ｐ＜０．０５）。但治疗后４小时，Ｅ－Ｓ出现一增高峰，而再灌注治疗不成功者（ｎ＝５）未见高峰出现。３．冠脉病变支数与该两种粘附分子测值无相关性。结论：ＡＭＩ再灌注治疗可降低增高的血清粘附分子；其早期高峰的出现?