2型糖尿病并发急性脑梗死患者血清ICAM、ALCAM、VCAM、PECAM-1水平及临床意义

目的 探讨2型糖尿病并发急性脑梗死患者血清细胞黏附分子-1 (ICAM)、活化白细胞细胞黏附分子(ALCAM)、血管细胞黏附分子-1 (VCAM)、血小板内皮细胞黏附分子-1(PECAM-1)的水平及临床意义.方法 选择2014年7月至2015年12月60例2型糖尿病并发急性脑梗死患者为研究对象,按照动脉粥样硬化严重程度不同分为:无斑块11例,稳定斑块22例,不稳定斑块27例.选择40例急性脑梗死患者及40例2型糖尿病患者作为疾病对照组;选健康者40名为健康对照组.采用双抗夹心法酶联免疫吸附试验(ELISA)法检测ICAM、ALCAM、VCAM、PECAM-1水平.采用美国国立卫生院卒中量表(NIHSS)行神经功能评估.结果 糖尿病并发脑梗死组ICAM、ALCAM、VCAM、PECAM-1水平高于其他3组,差异有统计学意义(P＜0.05),而脑梗死组、糖尿病组ICAM、ALCAM、VCAM、PECAM-1水平高于对照组,差异有统计学意义(P＜0.05),脑梗死组、糖尿病组ICAM、ALCAM、VCAM、PECAM-1水平比较,差异无统计学意义(P＞0.05).糖尿病并发脑梗死患者NIHSS评分(7.39±1.72)分高于脑梗死组患者(5.33±1.49)分,差异有统计学意义(t=4.376,P＜0.05).糖尿病并发脑梗死患者血清ICAM、ALCAM、VCAM、PECAM-1水平与NIHSS评分均呈正相关(r=0.559、0.619、0.421、0.451,P均＜0.007).随着糖尿病并发脑梗死患者颈动脉斑块严重程度的加重,血清ICAM、ALCAM、VCAM、PECAM-1水平呈上升趋势(P＜0.05).结论 ICAM、ALCAM、VCAM、PECAM-1在2型糖尿病并发急性脑梗死患者外周血血清中呈现异常升高,他们与2型糖尿病并发急性脑梗死患者的神经功能缺损及颈动脉斑块严重程度密切相关.

The relationship between the level of serum ICAM,ALCAM, VCAM and PECAM-1 in elderly patients with type 2 diabetes mellitus combined with acute cerebral infarction and its clinical significance

Objective To study relationship between the level of serum ICAM,ALCAM,VCAM and PECAM-1 in elderly patients with type 2 diabetes mellitus combined with acute cerebral infarction and its meaning.Methods From July 2014 to December 2015,60 patients with type 2 diabetes mellitus complicated with acute cerebral infarction were chosen as the research object.They were divided into three groups according to severity of atherosclerosis:no plaque in 11 cases,22 cases of stable plaques and unstable plaque 27 cases.40 cases with acute cerebral infarction patients and 40 cases of patients with type 2 diabetes were selected as a disease control;and other 40 healthy subjects were selected as healthy controls.ELISA were used to detect ICAM,ALCAM,VCAM and PECAM 1 level.Neural function evaluation was made by the U.S national institutes of health stroke scale (NIHSS).Results The ICAM,ALCAM,VCAM,PECAM 1 level in diabetic cerebral infarction group were higher than the other three groups,the difference was statistically significant (P＜0.05),while those of cerebral infarction group and diabetes group were higher than the control group,the difference was statistically significant (P＜0.05),and those of cerebral infarction group and diabetes group has no statistical significance (P＞0.05).NIHSS score of diabetic cerebral infarction patients was (7.39 ± 1.72),which was higher than that of patients with cerebral infarction group (5.33 ± 1.49),the difference was statistically significant (t=4.376,P =0.019,P＜0.05).The serum ICAM,ALCAM,VCAM,PECAM 1 level of diabetic cerebral infarction patients was a positively correlated with NIHSS score (r=0.559,P=0.007;r=0.619,P=0.000;r=0.421,P=0.018;r=0.451,P=0.007).With diabetic cerebral infarction is aggravating,the severity of carotid plaques in patients with serum ICAM,ALCAM,VCAM,PECAM-1 level is on the rise (P＜0.05).Conclusion ICAM,ALCAM,VCAM,PECAM-1 levels in peripheral blood serum of patients with type 2 diabetes mellitus complicated with acute cerebral infarction have an abnormal increase,and ICAM,ALCAM,VCAM,PECAM-1 level is closely related to the neurologic deficits and the severity of carotid artery plaque of type 2 diabetes mellitus complicated with acute cerebral infarction patients.