活化白细胞黏附分子与血小板内皮细胞黏附分子-1在2型糖尿病并发急性脑梗死患者中的变化及意义

目的探讨活化白细胞黏附分子(ALCAM)、血小板内皮细胞黏附分子-1(PECAM-1)的变化与2型糖尿病(T2DM)并发急性脑梗死患者神经功能、颈动脉斑块形成的关系。方法选取南阳医专第一附属医院收治的120例T2DM并发急性脑梗死患者为病例组A,120例不伴T2DM的急性脑梗死患者为病例组B,120例未发生脑血管疾病的志愿者为对照组。检测3组研究对象的血清ALCAM、PECAM-1水平,并根据颈动脉粥样硬化斑块特征、斑块内部新生血管分级进行分层对比;采用线性相关分析法分析血清ALCAM、PECAM-1与美国国立卫生研究院卒中量表(NIHSS)的相关性。结果病例组A的血清ALCAM、PECAM-1水平均高于病例组B、对照组,差异有统计学意义(P<0.05);病例组B的血清ALCAM、PECAM-1水平均高于对照组(P<0.05)。病例组A检出不稳定斑块患者67例,稳定斑块患者36例,未发现斑块患者17例;不稳定斑块患者的血清ALCAM、PECAM-1水平高于稳定斑块和无斑块患者,差异有统计学意义(P<0.05);稳定斑块患者的血清ALCAM、PECAM-1水平均高于无斑块患者(P<0.05)。病例组A中颈动脉粥样硬化斑块中新生血管2~3级患者的血清ALCAM、PECAM-1水平均高于新生血管0~1级患者,差异有统计学意义(P<0.05)。病例组A患者的NIHSS评分为(13.9±3.6)分,NIHSS评分与血清ALCAM、PECAM-1水平呈显著的正相关关系(r=0.573,r=0.530,P<0.05)。结论T2DM并发急性脑梗死患者血清ALCAM、PECAM-1水平较单纯的脑梗死患者显著增高,且与患者颈动脉粥样硬化斑块特征及内部血管形成、神经功能受损严重程度具有相关性。

Changes of ALCAM and PECAM-1 in T2DM patients with acute cerebral infarction and their relationship with neurological deficits and carotid plaque formation

Objective To explore the relationship between the changes of ALCAM and PECAM-1 and the neurological function and carotid plaque formation in patients with type 2 diabetes(T2DM)complicated by acute cerebral infarction.Methods Totally 120 pa?tients with T2DM complicated with acute cerebral infarction in our hospital were selected as case group A,120 patients with acute cere?bral infarction without T2DM as case group B,and 120 volunteers without cerebrovascular disease as the control group.Serum ALCAM and PECAM-1 levels of the three groups of study subjects were compared with each other according to the characteristics of carotid ath?erosclerotic plaque and the grading of neovascularization within the plaque;the linear correlation analysis method was used to analyze se?rum ALCAM,PECAM-1 and the correlation of the National Institute of Health stroke scale(NIHSS)scores.Results The serum ALCAM and PECAM-1 levels of case group A were higher than those of case group B and the control group,and the difference was statistically sig?nificant(P<0.05);the serum ALCAM and PECAM-1 levels of case group B were higher than those of the control group(P<0.05).In case group,67 patients with unstable plaques,36 patients with stable plaques,and 17 patients with no plaques;serum ALCAM and PECAM-1 levels of patients with unstable plaques were higher than stable The difference between patients with plaque and without plaque was statistically significant(P<0.05);the serum ALCAM and PECAM-1 levels of patients with stable plaque were higher than those without plaque(P<0.05).In case group A,the serum ALCAM and PECAM-1 levels of patients with carotid atherosclerotic plaque(grade 2 to 3)were higher than those of patients with neovascularization(grade 0 to 1),and the difference was statistically significant(P<0.05).The NIHSS score of patient group A was(13.9±3.6)points,the NIHSS score of patient group A was significantly positively correlated with serum ALCAM and PECAM-1 levels(r=0.573,r=0.530,P<0.05).Conclusion The levels of serum ALCAM and PECAM-1 in patients with T2DM complicated with acute cerebral infarction are significantly higher than those in patients with simple ce?rebral infarction,and they are related to the characteristics of carotid atherosclerotic plaque,internal blood vessel formation and the severity of neurological impairment.