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

发布时间：2018-05-28 03:22

本文选题：糖尿病 + 型　；参考：《重庆医学》2017年08期

【摘要】：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(P0.05),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(P0.05),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(P0.05)。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,P0.05)。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(P0.05)。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。
[Abstract]:Objective to investigate the levels and clinical significance of serum cell adhesion molecule-1 (ICAM-1), activated leukocyte adhesion molecule (ALCAMN), vascular cell adhesion molecule-1 (VCAM-1) and platelet endothelial cell adhesion molecule-1 (PECAM-1) in patients with type 2 diabetes mellitus complicated with acute cerebral infarction. Methods from July 2014 to December 2015, 60 patients with type 2 diabetes mellitus complicated with acute cerebral infarction were selected. According to the severity of atherosclerosis, there were 11 cases without plaque, 22 cases with stable plaque and 27 cases with unstable plaque. 40 patients with acute cerebral infarction and 40 patients with type 2 diabetes mellitus were selected as the disease control group and 40 healthy persons as the healthy control group. Double antibody sandwich enzyme linked immunosorbent assay (Elisa) was used to detect the level of ICAMAMALCAMV CAM-1. The National Institutes of Health Stroke scale (NIHSS) was used to evaluate neurological function. Results the level of ICAM-ALCAM-1 in patients with cerebral infarction was higher than that in the other three groups, the difference was significant (P 0.05), while the levels of ICAM-ALCAMCAM-1 in patients with cerebral infarction were higher than those in the control group (P 0.05), and the levels of ICAMCAM-1 in cerebral infarction group and diabetes group were significantly higher than those in the control group (P 0.05), and the levels of ICAMCAM-1 in cerebral infarction group and diabetes mellitus group were significantly higher than those in the control group. The difference was not statistically significant (P 0.05). The NIHSS score of diabetic patients with cerebral infarction was 7.39 卤1.72, which was significantly higher than that of patients with cerebral infarction (5.33 卤1.49). The difference was statistically significant (P 0.05). The serum levels of ICAM ALCAM-1 in patients with cerebral infarction were positively correlated with NIHSS scores (P < 0. 007, P = 0. 007, P = 0. 007, P = 0. 007, P = 0. 007, P = 0. 007, P = 0. 559, 0. 559, 0. 619, 0. 421). With the exacerbation of carotid plaque in patients with diabetes mellitus complicated with cerebral infarction, the level of serum ICAM ALCAM-1 in patients with cerebral infarction increased (P 0.05). Conclusion the level of ICAM ALCAM-1 in peripheral blood of patients with type 2 diabetes mellitus complicated with acute cerebral infarction is abnormally elevated, which is closely related to the neurological deficit and the severity of carotid plaque in patients with type 2 diabetes mellitus complicated with acute cerebral infarction.
【作者单位】：海南省海口市人民医院神经内科;
【分类号】：R587.2;R743.33

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