摘要
背景:促炎性细胞因子可以促进细胞间黏附分子1的表达,并促进白细胞与血管内皮细胞间的黏附,参与了进展性缺血性脑卒中的过程。目的:检测血清中可溶性细胞间黏附分子1及其相关因素对进展性缺血性脑卒中发生的预测作用。设计:以患者为研究对象,随机对照实验。单位:一所军医大学医院野战外科研究所的脑二科。对象:2000-02-01/2000-12-31解放军第三军医大学大坪医院神经内科的缺血性脑卒中患者238例,男117例,女121例。其中非进展性缺血性脑卒中186例。进展性缺血性脑卒中52例。干预:入院后,每天进行神经病学检查、加拿大脑卒中评分、体温、白细胞计数检查,分别于入院后1,3及7d进行血清黏附分子检查。主要观察指标:①进展性和非进展性缺血性脑卒中患者的生化检测特征。②与进展性缺血性脑卒中独立相关因素的检测。③进展性缺血性脑卒中与非进展性缺血性脑卒中后24h、第3,7天时各项独立相关因素检测结果。结果:脑卒中后24h内,进展性缺血性脑卒中患者的白计胞计数犤(8.4±1.2)×109L-1犦、血糖含量犤(45.8±5.1)g/L犦、纤维蛋白原含量犤(64.6±5.1)g/L犦及可溶性细胞间黏附分子1含量犤(261.4±9.7)μg/L犦明显高于非进展性缺血性脑卒中患者犤(6.7±1.3)×109L-1,(36.2±5.5)g/L,(44.0±6.2)g/L,(223.1±8.4)
BACKGROUND:Pro inflammatory cytokines can promote the expression of intercellular adhesion molecule 1(ICAM 1),and the adhesion of white cells to intravascular endothelium,thereby involving in the developing ischemic stroke.OBJECTIVE:To investigate the prognostic value of soluble intercellular adhesion molecule 1(sICAM 1) and its relative factors in the developing ischemic stroke.DESIGN:Randomized controlled study based on patients.SETTING:Department of neurology,the field surgery research institute in a military hospital of Chinese PLA.PARTICIPANTS:Between January 1st and December 31st 2000,total 238 patients with ischemic stroke received treatment at the Neurological Department of the Third Affiliated Hospital,the Third Military Medical University of Chinese PLA,including 117 males and 121 females,amongst which 186 cases were confirmed of none developing ischemic stroke and 52 cases developing ischemic stroke.INTERVENTIONS:After hospitalization,patients were subject to daily neurological examination,Canada stroke score(CSS),temperature and white blood cell(WBC) counting,sICAM was examined at 1,3 and 7 days after hospitalization.MAIN OUTCOME MEASURES:① The biochemical property of developing and non developing ischemic stroke.② Detection of developing ischemic stroke related independent factors.③ Comparison of independent correlative factors between developing ischemic stroke and non developing ischemic stroke at 24 hours 3 days and 7 days after the onset of stroke.RESULTS:Within 24 hours from the onset of stroke,the number of WBC was[(8.4± 1.2) × 109 L- 1] in developing ischemic stroke group,with blood glucose of[(45.8± 5.1) g/L],fibrinogen of[(64.6± 5.1) g/L] and sICAM 1 of[(261.4± 9.7) μ g/L],which were obviously higher than the corresponding[(6.7± 1.3)× 109 L- 1,(36.2± 5.5) g/L,(44.0± 6.2) g/L,(223.1± 8.4) μ g/L] in non developing ischemic stroke group,the difference was of statistical significance(t=2.368- 2.387,P< 0.01). The results of multiple factor analysis on developing ischemic stroke indicated that serum sICAM 1 was a risk factor independent of higher blood glucose,fibrinogen and CSS,and was obviously correlated with developing ischemic stroke(OR=2.9,95% CI=1.4- 6.3).There was significant change in sICAM 1,the number of WBC,blood glucose and fibrinogen at 24 hours,3 days and 7 days,as well as the scores for CSS at hospitalization in developing ischemic stroke group,which were significantly different from non developing ischemic group(t=2.345- 2.878,PCONCLUSION:sICAM 1 was proved obviously correlated with developing ischemic stroke,and can be used as a prognostic factor.
出处
《中国临床康复》
CSCD
北大核心
2005年第17期240-242,共3页
Chinese Journal of Clinical Rehabilitation
