急性心肌梗死患者PTCA术后再灌注损伤及细胞黏附分子的表达研究

目的观察急性心肌梗死(AMI)患者经皮冠状动脉腔内成形术(PTCA)前后外周血中细胞黏附分子(CAMs)的动态表达水平,探讨其与再灌注损伤的关系。方法采用流式细胞术和酶联免疫法分别测定79例AMI患者PTCA前,术后30min、2、6、12、24、72h的血小板颗粒糖蛋白(CD62p)、中性粒细胞表面黏附分子(CD11b)、可溶性细胞间黏附分子(sICAM-1)、可溶性血管黏附分子(sVCAM-1)的表达水平,36例冠状动脉造影正常者为对照组。结果 AMI患者术前CD62p、CD11b、sICAM-1和sV-CAM-1)的表达水平均明显高于对照组(P<0.01),术后30min AMI组CD62p水平与术前相比明显下降(P<0.05),但随之增高,至12h达高峰,72h降为术前水平,CD11b术后水平持续增高,12h达高峰,72h仍高于术前(P<0.05),而AMI组sICAM-1和sVCAM-1的术后表达水平持续增高,但无明显峰值。直线相关分析,AMI组术后12hCD62p水平与CD11b的表达水平呈正相关(r=0.673,P<0.01),而sICAM-1和sVCAM-1的术后24、72h表达水平呈正相关(r=0.562,r2=0.557,P<0.05)。结论 PTCA术可能导致AMI患者急性炎症反应,CD62p、CD11b、sICAM-1和sVCAM-1的异常表达增高与再灌注损伤有关。

Study on myocardial ischemia-reperfusion injury and the expression of cell adhesion molecules in patients with acute myocardial infarction after percutaneous transluminal coronary angioplasty

Objective To observe dynamic changes of cell adhesion molecules(CAMs) in patients with acute myocardial infarction(AMI) after percutaneous transluminal coronary angioplasty(PTCA),and to explore the relationship between the CAMs and myocardial ischemia-reperfusion injury(MIRI).Methods The level of CD62p and CD11b in 79 cases of patients were determined by flow cytometry(FCW),and the level of sICAM-1 and sVCAM-1 were determined by ELISA,before therapy and 30 mins,2,6,12,24,and 72 hours after PTCA.39 cases of ...