急性脑梗死病人白细胞流变特性及细胞黏附分子表达的变化及意义

①目的　探讨急性脑梗死（ＡＣＩ）病人白细胞流变特性及细胞黏附分子表达的变化及意义。②方法采用红细胞变形能力测定仪、体外血栓血小板黏附两用仪及酶联免疫吸附法（ＥＬＩＳＡ），检测了７２ 例ＡＣＩ病人、４２例脑出血病人及４８ 例健康人白细胞变形能力（ＬＤ）、白细胞黏附功能（ＬＡＦ）、白细胞ＣＤ１８ 表达及血清可溶性细胞间黏附分子－１（ｓＩＣＡＭ－１）和可溶性血管细胞间黏附分子（ｓＶＣＡＭ－１）浓度的变化。③结果　ＡＣＩ病人白细胞滤过指数（ＬＦＩ）、白细胞黏附率（ＬＡＲ）、白细胞ＣＤ１８表达及ｓＩＣＡＭ－１ 及ｓＶＣＡＭ－１ 浓度均明显升高，与脑出血病人及对照组比较差异有极显著性（ｔ＝ ７．６６３～１４．８７２，Ｐ＜ ０．００１），且这些指标变化随着ＡＣＩ病变程度加重而明显。ＡＣＩ病人ＬＦＩ和ＬＡＲ与白细胞ＣＤ１８ 表达、ｓＩＣＡＭ－１ 和ｓＶＣＡＭ－１ 浓度呈正相关（ｒ＝ ０．６８０～０．７２４，Ｐ均＜ ０．００１），ＬＦＩ与ＬＡＲ呈正相关（ｒ＝ ０．６８５，Ｐ＜ ０．００１）。④结论　白细胞流变特性和细胞黏附分子表达异常与ＡＣＩ发病和病变程度有密切关系

THE CHANGES AND SIGNIFICANCES OF LEUKOCYTE RHEOLOGIC CHARACTERISTICS AND EXPRESSION OF CELL ADHESION MOLECULE IN PATIENTS WITH ACUTE CEREBRAL INFARCTION

Objective\ To explore the changes and significances of leukocyte rheologic characteristics and expression of cell adhesion molecule in patients with acute cerebral infarction(ACI).\ Methods\ By using the erythrocyte deformability apparatus, platelet and thrombus adhesion dual purpose apparatus and enzyme linked immunosorbent assay(ELISA), the leukocyte deformability(LD), leukocyte adhesion rate(LAR), leukocyte CD 18 expression, serum soluble intercellular adhesion molecule 1(sICAM 1) and soluble vascular cell adhesion molecule(sVCAM 1) concentration were measured in 72 ACI patients ,42 cerebral hemorrhage patients and 48 controls.\ Results\ The leukocyte filtration index(LFI), LAR , leukocyte CD 18 expression and sICAM 1 and sVCAM 1 concentration were significantly higher in ACI patients than those in controls and cerebral hemorrhage patients( t=7.663-14.872,P < 0.001 ), and the changes of these indicators were more obvious along with the level of pathological changes of ACI. The LFI and LAR in ACI patients were positively correlated with leukocyte CD 18 expression, sICAM 1 and sVCAM 1 concentration( r=0.680-0.724, P <0.001), and LFI was positively correlated with LAR( r=0.685, P <0.001).\ Conclusion\ The abnormalities of leukocyte rheologic characteristics and cell adhesion molecules expression might be closely corralated with the occurance of ACI and the level of pathologic changes.