过敏性鼻炎患者血清sICAM—1水平测定及其意义

目的：了解过敏性鼻炎患者血清中可溶性细胞间粘附分子（ｓＩＣＡＭ）－１水平及意义。方法：采用抗体夹心ＥＬＩＳＡ法对３１例过敏性鼻炎患者血清ｓＩＣＡＭ－１水平进行测定。结果：过敏性鼻炎患者血清中ｓＩＣＡＭ－１水平与正常对照组比较明显增高（Ｐ〈０．００１）。结论：ｓＩＣＡＭ－１参与了过敏性鼻炎发病过程,且与临床症状有一定平行关系,推测ｓＩＣＡＭ－１可能在过敏性鼻炎炎症的加重与持续发生中有一定意义。     

血清可溶性L—选择素,sICAM—1,HBV DNA拷贝数及肝功能损害的相关性研究

目的 探讨Ｌ－ｓｅｌｅｃｔｉｎ（Ｌ－选择素）和ＩＣＡＭ－１（细胞间粘附分子－１）在乙型肝炎病毒感染造成肝功能损害过程中的作用。方法 定量检测４２例乙型肝炎病人血清ＨＢＶ ＤＮＡ拷贝数、可溶性Ｌ－选择素（ｓＬ－ｓｅｌｅｃｔｉｎ）、可溶性细胞产粘附分子－１（ｓＩＣＡＭ－１）及肝功能相关生化指标,并对结果进行统计分析。结果 ２２例ＤＮＡ阴性和２０例ＤＮＡ阳性病人血清ｓＬ－ｓｅｌｅｃｔｉｎ和ｓＩＣＡＭ－１水平均明显高于对照组（Ｐ〈０．０５）,但ＤＮＡ阴性组和阳性组之间的ｓＬ－ｓｅｌｅｃｔｉｎ和ｓＩＣＡＭ－１水平均无显著差异（Ｐ〉０．０５）;ＤＮＡ拷贝数与ｓＩＣＡＭ－１水平呈负相关（ｒ＝－０．５０１,Ｐ〈０．０５）;ＤＮＡ拷贝数与肝功能损害呈负相关;４２例乙肝病人的ｓＬ－ｓｅｌｅｃｔｉｎ和ｓＩＣＡＭ－１水平均与肝功能损害     

肝硬化患者血清可溶性细胞间粘附分子—1水平变化及意义

目的；探讨肝硬化患者血清可溶性细胞粘附分子－１（ｓＩＣＡＭ－１）水平变化，了解它与肝硬化患者肝功能损伤和门脉高压形成的关系。方法：用酶联免疫吸附法（ＥＬＩＳＡ）检测１７例正常人和３３例肝硬化患者血清ｓＩＣＡＭ－１。结果；肝硬化组血清ｓＩＣＡＭ－１水平显著高于对照组，且在肝功能分级中，呈现Ｃｈｉｌｄ Ｃ〉Ｃｈｉｌｄ Ｂ〉Ｃｈｉｌｄ Ａ的规律。相关分析显示肝硬化者血清ｓＩＣＡＭ－１与总胆红素及谷丙转氨     

冠心病患者血清可溶性细胞间粘附分子—1和血管细胞粘附分子—1的 …

检测各型冠心病患者循环中可溶性细胞间粘附分子－１和血管细胞粘附分子－１水平并分析它们与冠心病活动性之间的关系。方法：用ＥＬＩＳＡ法测定稳定型心绞痛患者者,不稳定型心绞痛患者,急性心肌梗塞患者和健康体检者血清ｓＩＣＡＭ－１和ｓＶＣＡＭ－１浓度。     

冠心病患者细胞间粘附分子—1,P—选择素和von Willebrand因子的 …

目的 探讨细胞间粘附分子－１（ＩＣＡＭ－１）、Ｐ－选择素（Ｐ－ｓｅｌｅｃｔｉｎ）、ｖｏｎ Ｗｉｌｌｅｂｒａｎｄ因子在冠心病中的表达特点和临床意义。方法 用酶联吸附法检测２８例稳定性心绞痛患者、２３例不稳定性心绞痛患者和２０例心肌梗死患者血中ＩＣＡＭ－１、Ｐ－ｓｅｌｅｃｔｉｎ、ｖＷＦ的表达。结果 冠心病患者血中ＩＣＡＭ－１、－ｓｅｌｅｃｔｉｎ和ｖＷＦ的表达较正常组增高,且在 ＵＡ组中的表达高于ＳＡ组     

冠心病患者细胞间粘附分子-1、P-选择素和von Willebrand因子的表达

探讨细胞间粘附分子－１（ＩＣＡＭ－１）、Ｐ－选择素（Ｐ－ｓｅｌｅｃｔｉｎ）．ｖｏｎＷｉｌｌｅｂｒａｎｄ因子（ｖＷＦ）在冠心病中的表达特点和临床意义。方法用酶联免疫吸附法（ＥＬＩＳＡ）检测２８例稳定性心绞痛患者（ＳＡ）、２３例不稳定性心绞痛患者（ＵＡ）和２０例心肌梗死患者（ＡＭＩ）血中ＩＣＡＭ－１、Ｐ－ｓｅｌｅｃｔｉｎ、ｖＷＦ的表达。结果冠心病患者血中ＩＣＡＭ－１、Ｐ－ｓｅｌｅｃｔｉｎ和ｖＷＦ的表达较正常组增高,且在ＵＡ组中的表达高于ＳＡ组,ＡＭＩ组的表达高于ＵＡ组。除Ｐ－ｓｅｌｅｃｔｉｎ在ＳＡ组与正常组间差别不显著外,其余均差异显著（Ｐ＜０．０１）。ＩＣＡＭ－１和ｖＷＦ在ＳＡ、ＵＡ及ＡＭＩ组均呈正相关。结论ＩＣＡＭ－１、Ｐ－ｓｅｌｅｃｔｉｎ和ｖＷＦ在不同类型冠心病患者有不同的增加,表明它们与冠心病的发生、发展及临床严重程度密切相关。     

自身免疫病患者血清胞间粘附分子检测的意义探讨

目的 了解进行性硬皮病（ＰＳＳ）、类风湿性关节炎（ＲＡ）、系统性红斑狼疮（ＳＬＥ）血清可溶性细胞间粘附分子（ｓＩＣＡＭ）１和３的水平及与病情的关系。方法 用进口酶联免吸附法（ＥＬＩＳＡ）试剂盒分别检测活动期ＰＳＳ、ＲＡ、ＳＬＥ患者与正常人血清ｓＩＣＡＭ－１以及ＰＳＳ、ＲＡ患者、正常人血清ｓＩＣＡＭ－３的含量，比较其水平的差异。结果 正常对照组（２０例）ｓＩＣＡＭ－１和ｓＩＣＡＭ－３水平分别为２０２     

病毒性肝炎肝纤维化患者血浆的细胞间粘附分子—1测定及其临床意义

目的探讨细胞间粘附分子－１（ＩＣＡＭ－１）与病毒性肝炎肝纤维化的关系。方法用ＥＬＩＳＡ法检测了３９例病毒性肝炎肝纤维化患者和３０例健康人血浆ｓＩＣＡＭ－１、Ⅳ型胶原、层粘连蛋白含量。结果显示病毒性肝炎肝纤维化患者血浆ｓＩＣＡＭ－１、Ⅳ型胶原、层粘连蛋白水平显著高于健康组，且在肝纤维化分级中呈ｃｈｉｌｄ Ｃ＞ｃｈｉｌｄ Ｂ＞ｃｈｉｌｄ Ａ，相关性分析显示ｓＩＣＡＭ－１与Ⅳ型胶原、层粘连蛋白水平呈正相关（ｒ＝０．７９～０．８９，ｒ＝０．６２～０．７３）。结论病毒性肝炎肝纤维化患者血浆ｓＩＣＡＭ－１升高与肝细胞损伤有关，可反映肝纤维化的严重程度。     

大鼠脑缺血再灌注区细胞间粘附分子1表达与白细胞浸润的实验研究

目的：观察大鼠脑缺血－再灌注后不同时间缺血区细胞间粘附分子－１（ＩＣＡＭ－１）的表达和中性粒细胞的浸润以及神经细胞的损伤情况。方法：４０只Ｗｉｓｔａｒ大鼠分为对照组、假手术组和缺血２小时再灌注２、４、１２、２４、４８、９６小时组,分别用免疫组织化学和组织切片方法检测大脑中动脉阻塞２小时再灌注不同时间点局部脑组织ＩＣＡＭ－１蛋白表达及中性粒细胞浸润情况。结果：大鼠脑缺血 灌液２小时局部脑组织ＩＣＡＭ     

创伤后多脏器功能衰竭患者细胞粘附分子和补体激活成分水平的变化及意义

目的：探讨创伤后多器官功能衰竭（ＭＯＦ）患者血浆粘附分子和补体活化成分水平的变化及意义。方法：采用酶联免疫吸附法（ＥＬＩＳＡ）检测３６例创伤后ＭＯＦ患者及３１例创伤患者和３５例健康人外周血白细胞ＣＤ１８的变化、血浆可溶性细胞间粘附分子－１（ｓＩＣＡＭ－１）,可溶性血管细胞间粘附分子－１（ｓＶＣＡＭ－１）和血浆补体活化片段（ｓＣ５ｂ－９）浓度的变化。结果：ＭＯＦ患者白细胞ＣＤ１８的表达、ｓＩＣＡＭ－     

Acute ischemic stroke in a trauma cohort: Incidence and diagnostic challenges

Introduction

Diagnosis of acute ischemic stroke is critical for acute intervention. Its diagnosis may be obscured in trauma patients due to confounding injuries. We report its incidence in trauma patients following their presentation at our institution.

急性缺血性脑卒中患者血清小而密低密度脂蛋白胆固醇水平与心脑血管狭窄程度的相关性研究

目的　研究急性缺血性脑卒中患者血清小而密低密度脂蛋白胆固醇（small and low density lipoprotein cholesterol,sdLDL-C）与心脑血管狭窄程度的相关性。方法　收集上海市交通大学附属瑞金医院神经内科2015 年5 月 ~2017 年10 月期间,已确诊为缺血性脑卒中患者146 例。按照其血管造影（MRA）和颈部超声结果,分为血管正常组 18 例、血管闭塞组34 例和血管狭窄组94 例( 包括血管单支狭窄组28 例、血管多支狭窄组66 例),分别检测其血清胆 固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、脂蛋白a[Lp(a)] 和小而密 低密度脂蛋白胆固醇（sdLDL-C）水平。另选取对照组112 例。比较各组间sdLDL-C 的检测结果,并用多元logistic 回 归分析各检测项目与急性缺血性脑卒中的关系。结果　病例组中TG,Lp(a) 和sdLDL-C 明显高于对照组,差异均具有 统计学意义（t=-6.011, -2.776, -3.744,均P ＜ 0.05）;对照组的HDL-C 明显高于病例组,差异具有统计学意义（t=9.665, P ＜ 0.05）;TG,Lp(a),sdLDL-C 和sdLDL-C/LDL-C 比值与急性缺血性脑卒中的发生呈正相关（相关系数分别为0.316, 0.166,0.20,0.243）;血管闭塞组sdLDL-C 的血清水平（33.77±14.57mmol/L）明显高于血管正常组sdLDL-C 的血 清水平（25.38±12.29mmol/L）;血管多支狭窄组sdLDL-C 的血清水平（30.10±13.61 mmol/L）明显高于单支狭窄组 （20.88±6.46 mmol/L）;血管闭塞组LDL-C,sdLDL-C 明显高于血管正常组和血管狭窄组,差异具有统计学意义（F=3.34, 3.719, 均P<0.05）;多支狭窄组血清TG,TG,LDL-C,sdLDL-C 和sdLDL-C/LDL-C 结果均高于单支狭窄组,差异均 具有统计学意义（t=-3.381, -2.372, -2.17,-4.323,-2.193,均P ＜ 0.05）。结论　急性缺血性脑卒中患者sdLDL-C 水 平升高,且升高水平与血管病变程度密切相关。     

急性缺血性脑卒中静脉溶栓后出血预测模型的构建与验证

目的 探讨急性缺血性脑卒中患者接受静脉溶栓治疗后发生出血的危险因素,构建预测模型.方法 纳入2014年1月—2020年12月于深圳市某三级甲等医院进行静脉溶栓治疗的急性缺血性脑卒中患者462例,将其分为出血组(n=264)和未出血组(n=198).使用二分类Logistic回归模型分析相关危险因素,构建预测模型并进行验...     

Soluble adhesion molecules in acute ischemic stroke

BACKGROUND: Inflammatory adhesion molecules play a key role in the development of ischemic lesions. Elevated plasma concentrations of soluble adhesion molecules are reported in stroke patients, but data are still controversial. Our aim was to explore the potential association of plasma levels of soluble (s) intercellular and vascular cellular adhesion molecules-1 (sICAM-1 and sVCAM-1), sE-selectin and sL-selectin with acute ischemic stroke. METHODS: At our university hospital in Zagreb, Croatia, we prospectively enrolled 67 subjects with acute ischemic stroke, as well as 76 consecutive healthy individuals as controls who were visiting the centre for reasons unrelated to stroke. Serum concentrations of the molecules of interest were determined by means of quantitative sandwich enzyme immunoassay. RESULTS: Mean levels of sICAM-1 (p < 0.001), sVCAM-1 (p < 0.034) and sE-selectin (p < 0.002) were higher in patients than in controls, whereas sL-selectin was lower in patients (p = 0.043). In patients, levels of soluble adhesion molecules were independent of age and sex except for sL-selectin, which was inversely correlated with age (r = -0.260, p = 0.034) and higher in women (p = 0.006) and diabetics (n = 14; p = 0.004). Serum levels did not differ significantly with respect to carotid atherosclerotic disease, smoking status, hypertension or hypercholesterolemia. As well as correlating with each other, concentrations of soluble adhesion molecules in patients correlated with traditional biochemical markers of inflammation: total leukocyte count, erythrocyte sedimentation rate (ESR) and C-reactive protein level. Concentrations of sICAM-1 and high-density lipoprotein-cholesterol and ESR were identified as significant independent predictors/indicators of acute ischemic stroke. CONCLUSIONS: Acute ischemic stroke is associated with elevated plasma levels of sICAM-1, sVCAM-1 and sE-selectin, independent of age, sex and other recognized risk factors for stroke. Decreased levels of sL-selectin are associated with acute stroke. The observed changes in serum concentrations of adhesion molecules indicate inflammatory process occurring during acute cerebral ischemia.     

阿托伐他汀对急性缺血性卒中梗死体积的影响

目的:探讨他汀在缺血性卒中急性期对梗死体积的影响。方法:前瞻性的纳入24h内急诊入院的急性缺血性卒中患者,随机分成他汀组(40mg/d,2周)和对照组。发病1周内,进行头颅磁共振(MRI)检查,并在3个月随访时予以复查,分析两组患者梗死体积变化的情况,并采用Logistic回归分析影响梗死体积变化的因素。同时进行血脂、炎症因子和神经功能评分等评估。结果:共39例患者接受了2次头颅MRI检查。其中阿托伐他汀组患者20例,对照组患者19例。两组患者的梗死体积变化率差异有统计学意义(P<0.01)。阿托伐他汀组患者发病后3个月梗死体积较发病时减少的比例显著高于对照组(71.4%对28.6%,P<0.05)。多因素Lo-gistic回归分析,显示不用他汀治疗以及入院时NIHSS评分高是梗死体积增大的独立危险因素。结论:缺血性卒中急性期使用他汀可能有利于患者梗死体积的局限。梗死体积的变化可能成为临床神经功能改善的一个补充观察指标来进一步评价药物干预的效果。他汀类药物是否能局限脑梗死体积和改善临床预后仍需进一步临床研究证实。     

缺血核心体积结合相对灌注率在评估急性脑卒中血管再通及预后中的研究

目的探讨急性脑卒中血管内机械取栓(endovascular thrombectomy,EVT)治疗前缺血核心体积(ischemic core volume,ICV)结合相对灌注率在评估血管再通及预后中的价值.材料与方法回顾性分析在本院就诊的急性缺血性脑卒中患者病例200例,所有患者均于治疗前24 h内行MRI检查.灌注...     

Associations of apolipoprotein E exon 4 and lipoprotein lipase S447X polymorphisms with acute ischemic stroke and myocardial infarction.

BACKGROUND: Because apolipoprotein E (apoE) and lipopoprotein lipase (LPL) polymorphisms interact with each other and with other factors to affect lipid metabolism, we sought to determine their separate and combined effects in association with ischemic vascular disease. METHODS: We performed a case-control study of 816 subjects: 246 acute ischemic stroke patients, 234 acute myocardial infarction patients, and 336 controls. APOE exon 4 and LPL S447X genotypes were determined. RESULTS:APOE epsilon2 and epsilon4 homozygotes were increased in stroke (4.5% vs. 1.0%, p = 0.008), while in myocardial infarction the epsilon4 allele was increased (12.6% vs. 9.5%, p = 0.006) but epsilon2 was decreased (3.7% vs. 12.1%, p = 0.000006). For subjects with either APOE epsilon2 or epsilon4 alleles, LPL X alleles were increased in vascular disease (OR = 2.2, p = 0.01). LPL X alleles displayed opposite tendencies toward association with disease when subjects were divided by sex, smoking, or APOE genotype. Meta-analysis and regression analysis of previous studies supported the sex and smoking dichotomies. CONCLUSION: This is the first report of an association of vascular disease with an interaction of APOE exon 4 and LPL S447X genotypes. Therefore, APOE genotypes and LPL S447X interactions with apoE, sex, and smoking may affect the risk of myocardial infarction and ischemic stroke.     

Prothrombotic conditions, oral contraceptives, and the risk of ischemic stroke

BACKGROUND: The role of inherited prothrombotic conditions, including factor V Leiden (FV G1691A), prothrombin G20210A, and the methylenetetrahydrofolate reductase (MTHFR) C677T genotype, in the pathogenesis of ischemic stroke is not well established. The effects of these factors may be potentiated by the use of oral contraceptives, analogous to observations in venous thrombosis. METHODS: Patients (n = 193) were women aged 20-49 years with ischemic stroke. Controls (n = 767) were women without arterial thrombosis stratified for age, calendar year of the index event, and residence. The relative risk of ischemic stroke was estimated with unconditional logistic regression, adjusted for stratification variables. FINDINGS: Factor V Leiden and MTHFR 677TT were more common in patients than in controls [odds ratio (OR): 1.8; 95% confidence interval (CI): 0.9-3.6 respectively OR: 1.5; 95% CI: 0.9-2.6]. The frequency of prothrombin G20210A was similar in cases and controls. Carriers of FV Leiden using oral contraceptives had a 11.2-fold (95% CI: 4.3-29.0) higher risk of ischemic stroke than women without either risk factor. Women with MTHFR 677TT using oral contraceptives had a 5.4-fold (95% CI: 2.4-12.0) higher risk than women without these risk factors. INTERPRETATION: These data suggest that carriers of FV Leiden or MTHFR 677TT who use oral contraceptives have an increased risk of ischemic stroke. When these findings are confirmed, a cost-effectiveness analysis should indicate whether ischemic stroke could be prevented with genetic testing before the start of oral contraceptives.     

颈动脉粥样硬化与缺血性卒中危险分层相关性分析

目的观察急性缺血性卒中患者的颈动脉粥样硬化与卒中复发风险分层的关系。方法采用Essen卒中风险评分量表(ESRS)对82例急性缺血性卒中患者的危险因素评估后分为ESRS≥3分组(40例)和ESRS 0～2分组(42例),经彩色多普勒超声仪对两组进行评估,比较两组颈动脉粥样硬化特征和程度。结果 ESRS≥3分组与ESRS 0～2分组相比,ESR≥3分组中高龄、高血压、糖尿病和本次卒中之前有TIA或缺血性卒中的比例明显较高(P<0.05)。ESRS≥3分组颈动脉内-中膜厚度(IMT),斑块(尤其多发斑块)发生率,脂质性、钙化性斑块发生率,中、重度粥样硬化发生率明显高于ESRS 0～2分组(P<0.05)。经多因素非条件Logistic回归分析,颈总动脉IMT≥1.0 mm,脂质性、钙化性斑块,颈动脉粥样硬化程度与ESRS≥3分组卒中复发的危险因素成正相关。结论颈动脉粥样硬化与缺血性卒中复发高危风险密切相关。颈总动脉IMT、颈动脉粥样硬化的严重程度可作为卒中高危复发风险的预测指标。     

非瓣膜性心房颤动患者并发缺血性脑卒中的多因素分析

目的探索非瓣膜性心房颤动患者并发缺血性脑卒中的危险因素及保护因素。方法对入选的901例非瓣膜性心房颤动患者进行随访3年,收集其一般状况、相关疾病病史和服用药物的临床资料,按照随访期间是否发生缺血性脑卒中分为卒中组(n=39)和非卒中组(n=862),并应用多因素Logistic回归分析其发生卒中的危险因素及保护因素。结果发生缺血性脑卒中的危险因素有年龄(OR=1.087,95%CI:0.240~1.315)、心力衰竭病史(OR=2.245,95%CI:1.033~4.880)、缺血性卒中或短暂性脑缺血发作病史(OR=5.265,95%CI:2.545~10.889)、其他全身性栓塞病史(OR=5.034,95%CI:1.307~19.386)、利尿剂的应用(OR=3.505,95%CI:1.715~7.165);保护因素有血管紧张素受体阻滞剂(ARB)的应用(P0.05,OR=0.316,95%CI:0.122~0.815)。结论年龄、心力衰竭、缺血性卒中或短暂性脑缺血发作、其他全身性栓塞病史,以及利尿剂的应用,是非瓣膜性心房颤动患者并发缺血性脑卒中的独立危险因素,而ARB的应用是保护因素。