维持性血液透析尿毒症患者sICAM-1和E-选择素水平的变化

目的 :测定维持性血液透析 (MHD)的尿毒症患者血浆中细胞间黏附分子 1(ICAM 1)和E 选择素的水平 ,探讨MHD患者动脉粥样硬化的病理机制。方法 :应用双抗夹心ELISA法 ,测定 10 5例MHD患者和 2 5例健康人 (对照组 )血浆中ICAM 1和E 选择素的水平 ,同时用B超测定患者颈动脉粥样硬化的情况 ,记录两组的血压并测定其血脂、血糖、血尿素和肌酐的水平。结果 :①MHD组血浆ICAM 1和E 选择素的水平均明显高于对照组 (P <0 .0 1)。MHD组中 ,有颈动脉硬化者血浆I CAM 1和E 选择素的水平明显高于无颈动脉硬化组 (分别为P <0 .0 1和P <0 .0 5)。②MHD组血浆ICAM 1与E 选择素以及与甘油三酯 (TG )均呈显著的正相关 (r值分别为0 .62及 0 .60 )。血浆ICAM 1的水平与舒张压也呈正相关(r=0 .41)。结论 :MHD患者存在明显的血管内皮功能损伤。血浆ICAM 1和E 选择素可作为MHD患者血管内皮损伤的标志物 ,其与MHD患者的动脉粥样硬化密切相关

Changes of intercellular adhesion molecule-1 and E-selectin levels in plasma of uremic patients treated with maintaining hemodialysis

AIM: To detect the levels of ICAM-1 and E-selectin in plasmas from uremic patients treated by means of maintaining hemodialysis (MHD) and explore the pathological mechanism of atherosclerosis in MHD patients. METHODS: The levels of ICAM-1 and E-selectin in plasmas from the 105 MHD patients and 25 healthy persons (control group) were detected by dual antibody sandwich ELISA. The cervical atherosclerosis of the patients was examined by type B ultrasonography. Simultaneously, the blood pressures of the patients and control group were taken and recorded, as well as the biochemical criterions in their blood were detected. RESULTS: (1) The plasma levels of ICAM-1 and E-selectin in MHD patients were significantly higher than those in the control group, respectively (P < 0.01), and in MHD group the above indexes in patients with cervical atherosclerosis were significantly higher than those without cervical atherosclerosis (P < 0.01,P < 0.05). (2) In MHD group, the plasma ICAM-1 level was positively correlated with E-selectin and triglycerides (TG) levels(r = 0.62 and 0.60, respectively), and with the diastolic pressure(r = 0.41,P < 0.05). CONCLUSION: The impairment of vascular endothelial function was obvious in uremic patients with MHD. The changes of ICAM-1 and E-selectin could be accepted as biochemical criterions of vascular endothelial injury. The two adhesion molecules have close relationship with atherosclerosis in MHD patients.