摘要
目的探讨脑梗死患者脑微出血(cerebral microbleeds,CMB)期血清细胞间粘附分子-l(inter-cellular adhesion molecule-1,ICAM-1)、内皮素-1(endothelin-1,ET-1)水平的变化及临床意义。方法连续选择南京军区总医院自2011年1月～2011年8月首次发病的急性脑梗死患者110例,所有患者均在7 d内完成常规序列磁共振成像及磁敏感成像(susceptibility weighted imaging,SWI)。根据磁共振成像检查表现分为CMBs组和无CMB组,并依据CMBs的数目进行严重程度分级。对患者脑卒中2个月后血清ICAM-1、ET-1水平进行检测。结果 45例CMBs组患者ICAM-1(332±46.3)ng/ml及ET-1水平(71.39±12.7)ng/ml,与65例无CMBs组患者比较差异具有显著性(t=-2.703,P=0.010;t=-3.815,P<0.001),调整年龄、性别、高血压病史、糖尿病史、吸烟史混杂因素,发现ICAM-1[(Odds ratio,OR)=1.023,95%(confidence interval,CI)1.008～1.038;P=0.003;r=0.406,P>0.008]及ET-1(OR=1.070,95%CI 1.012～1.131,P=0.018;r=0.486,P<0.001)水平仍然与CMBs呈正相关。结论 CMB患者脑梗死恢复期血浆ICAM1、ET-1水平较高,并且与CMBs严重程度呈正相关,提示CMBs内皮功能明显受损。
Objective To investigate the relation between cerebral microbleeds （CMBs） and the serum levels of intercellular adhesion molecule-1 （ICAM-1） and Endothelin-1 （ET-1） in patients with ischemic stroke. Methods One hundred and ten consecutive patients with acute ischemic stroke between July 2011 and May 2012 were enrolled. All patients received cranial magnetic resonance imaging （MRI）within 7 days, including conventional and susceptibility weighted imaging（SWI）. According to MRI findings, the patients were divided into CMBs and non-CMBs groups. The number and degrees of microbleeds were counted and evaluated. Serum ICAM-1 ,ET-1 were measureed two months after stroke. Compared the ICAM-1 ,ET-1 levels between CMBs and non-CMBs groups. Results Among a total of 110 patients, 45 （40. 9% ） patients were detected with CMBs. Serum ICAM-1 （332 ±46 3）ng/ml and ET-1 （71.39 ±12. 7）ng/ml in CMBs groups were higher than that in non-CMBs groups（t = - 2. 703, P = 0. 010 ; t = - 3.815, P〈0. 001 ）. Through logistic regression analy- sis, adjust to age, gender, history of hypertension, history of diabetes, the history of smoke, ICAM-1 （OR = 1. 023,95%CI 1. 008-1. 038, P = 0. 003） and ET-1 （OR = 1. 079,95%CI 1. 012±1. 131, P = 0. 018） were sig- nificantly associated with CMBs. Further, the degrees of CMBs had positive correlation with ICAM-1 （r = 0. 406,P = 0. 008）and ET-1 （r= 0. 486,P〈0. 001）. Conclusions ICAM-1, ET-1 was significantly associated with CMBs in ischemic stroke, and were correlated positively with the degrees of CMBs. It suggests that vas- cular endothelial function may be damaged in stroke patients with CMBs.
出处
《卒中与神经疾病》
2013年第4期205-208,共4页
Stroke and Nervous Diseases
关键词
脑梗死
微出血
血管内皮功能
细胞间粘附分子-1
内皮素-1
Ischemic stroke Cerebral microbleeds Vascular endothelial function Intercellular adhe-sion molecule-1 Endothelin-1
