脑梗死患者血浆ICAM-1、CD62p、CD63的动态变化及其临床意义

目的 探讨脑梗死患者血浆细胞间黏附分子（ICAM-1）、血小板表面P选择素（CD62p）、溶酶体颗粒糖蛋白53（CD63）的动态变化及其临床意义。方法 用流式细胞仪观察60例脑梗死患者发病3d、7d、14d外周血中ICAM-1、CD621，CD63的变化，并与20名健康者进行比较。结果 脑梗死3d、7d上述3项指标明显高于14d及正常对照组（均P〈0．05），而3d与7d间则差异不显著（P〉0．05）；ICAM-1与CD62p、CD63间无相关关系（r=0．1385、0．1632，均P〉0.05）；CD62p与CD63呈显著正相关（r=0.746，P〈0．05）；3项指标与临床神经功能缺损程度评分无相关性（r=0.1462、0.2145、0．368，均P〉0．05）。结论 脑梗死后ICAM-1表达增强，介导了粒细胞与脑血管内皮发细胞间的黏附，同时血小板表面CD62p、CD63表达增强，反映了血小板的活化程度与功能状态，评介导了血小板与中性粒细胞及内皮细胞间的黏附，促进了脑梗死的发生和发展，加重了脑组织的损伤。

Dynamic changes and its clinical significance of ICAM-1, CD62p and CD63 in plasma of patients with cerebral infarction

Objective To explore dynamic changes and its clinical significance of intercellular adhesion molecule-1 (ICAM-1), adhesion p-selectin (CD62p) and CD63 in plasma of patients with cerebral infarction (CI). Methods The changes of ICAM-1, CD62p and CD63 were assessed by flow cytometry on 3, 7 and 14 day from onset of cerebral infarction in 60 patients and compared with 20 healthy people. Results The levels of ICAM-1, CD62p and CD63 at 3 and 7 day were remarkably higher than those at 14 day and in control group (all (P<)0.05), but there was no significant difference between 3 day and 7 day in patient group ((P>)0.05). No correlation was found between ICAM-1 and CD62p, CD63 ((r=)0.1385, (r=)0.1632, all (P>)0.05). There was a positive correlation between CD62p and CD63 ((r=)0.746, (P<)0.05). The three markers were not related with the scores of neurologic impairment ((r=)0.1462, (r=)0.2145 and (r=)0.368,all (P>)0.05).Conclusions High expression of ICAM-1 after cerebral infarction mediates granulocyte adherence to endothelial cells of cerebral vessels. Meanwhile, increased expression of glycoprotion CD62p and CD63 at platelet surface represents the activation and functional status of platelets, and mediates platelet adherence to neutrophil and endothelial cells. The above changes accelerate the onset and development of cerebral infarction and enhance damage of brain.