细胞间粘附分子-1和碱性成纤维细胞生长因子在脑梗死中的作用

目的了解脑梗死急性期血清可溶性细胞间粘附分子-1(sICAM-1)和碱性成纤维细胞生长因子(bFGF)的含量变化,以及在脑梗死发生发展过程中的作用.方法采用酶联免疫吸附法(ELISA) 检测55例急性期脑梗死患者和32例其他疾病对照组及30例正常健康人为对照组,测量血清sICAM-1和bFGF 含量.结果 (1)脑梗死患者血清sICAM-1和bFGF含量分别为766.2 μg/L±178.8 μg/L和17.4 μg/L±8.2 μg/L,较其他疾病对照组分别529.6 μg/±76.7 μg/L和8.3 μg/L±2.8 μg/L,正常健康对照组分别520.7 μg/±115.9 μg/L和5.8 μg/L±2.7 μg/L,差异有显著意义(P=0.000).(2)相关分析脑梗死时血清sICAM-1含量与bFGF含量呈正相关(r=0.471,P=0.000),与外周血白细胞数呈正相关(r=0.285,P=0.035),与神经功能缺损评分呈负相关(r=-0.333,P=0.013),而与血脂水平无明显相关关系(胆固醇r=-0.042,P=0.758;甘油三脂r=0.061,P=0.657).(3)脑梗死患者血清sICAM-1和bFGF含量与高血压史关系不密切.而bFGF含量与病灶大小有关.结论 ICAM-1和bFGF可能通过炎症机制参与了脑梗死的病理生理过程;急性期监测血清sICAM-1和bFGF含量变化有助于判断病情轻重和病灶大小.

Change of serum soluble intercellular adhesion molecule and basic fibroblast growth factor in patients with acute cerebral infarction and its clinical significance

OBJECTIVE: To explore the changes of the levels of soluble intercellular adhesion molecule-1 (sICAM-1) and basic fibroblast growth factor (bFGF) in serum of patients with acute cerebral infarction, and the effects of sICAM-1 and bFGF on cerebral infarction. METHODS: ELISA was used to detect the serum sICAM-1 and bFGF of 55 patients with acute cerebral infarction (within 2 days) as well as 32 patients diagnosed as with other neurologic diseases (20 patients with sciatica and 12 with trigeminal neuralgia) and 30 healthy persons as controls. RESULTS: (1) Both serum sICAM-1 and bFGF in the infarction group were significantly higher [(766.2 +/- 178.8) micro g/L and (17.4 +/- 8.2) micro g/L respectively] than in other disease control group [(529.6 +/- 76.7) micro g/L and (8.3 +/- 2.8) micro g/L respectively] and normal control group [(520.7 +/- 115.9) micro g/L and (5.8 +/- 2.7) micro g/L respectively] (P = 0.000). (2) Correlation analysis showed that there was a positive correlation between the level of serum sICAM-1 and bFGF (r = 0.471, P = 0.000), the level of sICAM-1 was also positively correlated with the number of leukocytes at acute stage (r = 0.285, P = 0.035), and a negative correlation between sICAM-1 and European stroke scale (r = -0.333, P = 0.013) was found. No significant correlation was observed between the level of sICAM-1 and the levels of serum cholesterol (r = -0.042, P = 0.758) or triglyceride (r = 0.061, P = 0.675). (3) Blood pressure seemed to have no influence on the content of sICAM-1 and bFGF after cerebral infarction, while the level of serum bFGF with large infarct size was obviously higher at acute stage. CONCLUSION: The levels of sICAM-1 and bFGF increase significantly in the patients with acute cerebral infarction. sICAM-1 and bFGF mayin participate in the pathophysiologic process through inflammatory mechanism. The detection of serum sICAM-1 will be helpful in estimating the clinical severity and the determination of bFGF will be helpful in estimating the size of infarct lesion at acute stage of cerebral infarction.