脑梗死患者脑微出血与血管内皮损伤标志物ICAM-1、eNOS、sTM的相关性
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摘要
目的探讨脑梗死(cerebral infarction,CI)患者脑微出血(cerebral microbleeds,CMBs)与血管内皮损伤标志物细胞间黏附分子-1(intercellular adhesion molecule-1,ICAM-1)、内皮型一氧化氮合成酶(endothelial nitric oxide synthase,eNOS)、可溶性血栓调节蛋白(soluble thrombokinin,sTM)的相关性及其临床意义。方法收集河北大学附属医院2017年7月至2018年6月于神经内科住院的CI患者106例,经颅脑SWI检查确诊无CMBs者37例(Ⅰ组)与合并CMBs者69例(II组)。收集患者的基本资料和血清,并采用酶联免疫分析法定量测定ICAM-1、eNOS、sTM含量,分析其与CI后CMBs的关系。结果急性期Ⅱ组患者ICAM-1、eNOS和sTM含量明显高于Ⅰ组患者(P<0.05)。3个月后恢复期Ⅱ组患者的血清内ICAM-1和sTM含量依旧高于I组患者,而I组患者恢复期的血清内eNOS含量高于Ⅱ组患者。结论血浆ICAM-1、eNOS和sTM升高与CI后CMBs关系紧密,其含量变化对CMBs的发生有一定预测作用。
Objective To investigate the correlation between cerebral microhemorrhage(CMBs) in patients with cerebral infarction(CI) and the markers of vascular endothelial injury: intercellular adhesion molecule-1(ICAM-1), endothelial nitric oxide synthase(eNOS) and soluble thrombokinin(sTM), and its clinical significance.Methods A total of 106 CI patients admitted to the Neurology Department of the Affiliated Hospital of Hebei University from July 2017 to June 2018 were collected.After craniocerebral SWI examined and confirmed no CMBs 37 cases(groupⅠ) and merge CMBs 69 cases(group II). Basic data and serum of patients in thetwo groups were collected,and the contents of ICAM-1,eNOS and s TM were quantitatively determined by ELISA to discuss the relationship between them and CMBs after CI. Results The levels of eNOS,ICAM-1 and s TM in groupⅡof patients were significantly higher than the levels of group Ⅰ. Three months later,group Ⅱ patients of cerebral infarction convalescence serum ICAM-1 and s TM level was still higher than the group of patients,for group I patients recovery of serum eNOS level higher than group Ⅱ. Conclusion The increased plasma ICAM-1,eNOS and s TM are closely related to CMBs after CI,and the changes in their contents have a certain predictive effect on the occurrence of CMBs.
Objective To investigate the correlation between cerebral microhemorrhage(CMBs) in patients with cerebral infarction(CI) and the markers of vascular endothelial injury: intercellular adhesion molecule-1(ICAM-1), endothelial nitric oxide synthase(eNOS) and soluble thrombokinin(sTM), and its clinical significance.Methods A total of 106 CI patients admitted to the Neurology Department of the Affiliated Hospital of Hebei University from July 2017 to June 2018 were collected.After craniocerebral SWI examined and confirmed no CMBs 37 cases(groupⅠ) and merge CMBs 69 cases(group II). Basic data and serum of patients in thetwo groups were collected,and the contents of ICAM-1,eNOS and s TM were quantitatively determined by ELISA to discuss the relationship between them and CMBs after CI. Results The levels of eNOS,ICAM-1 and s TM in groupⅡof patients were significantly higher than the levels of group Ⅰ. Three months later,group Ⅱ patients of cerebral infarction convalescence serum ICAM-1 and s TM level was still higher than the group of patients,for group I patients recovery of serum eNOS level higher than group Ⅱ. Conclusion The increased plasma ICAM-1,eNOS and s TM are closely related to CMBs after CI,and the changes in their contents have a certain predictive effect on the occurrence of CMBs.
引文
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[3] 邹翠洁,张玉,许跃奇,等.3.0T MR磁敏感加权成像对脑微出血灶的诊断效能[J].山东医药,2015,55(47):48-50.DOI:10.3969/j.issn.1002-266X.2015.47.018.
[4] 张继,赵小二,吴慧,等.MRSWI在脑微出血及脑血管畸形中的应用研究[J].实用放射学杂志,2015,31(1):12-15.DOI:10.3969/j.issn.1002-1671.2015.01.004.
[5] MARCO P,ANDREAS C,GREGOIRE B,et al.Cerebral small vessel disease in patients with spontaneous cerebellar hemorrhage[J].Journal of neurology,2019,266(3):625-630.DOI:10.1007/s00415-018-09177-w.
[6] 王应天,林洪生,樊慧婷,等.ICAM-1在肿瘤转移中的作用及研究进展[J].河北医药,2019,41(2):269-272.DOI:10.3969/j.issn.1002-7386.2019.02.029.
[7] 朱磊,张彦红,时光,等.益脑康对动脉粥样硬化性急性脑缺血大鼠血清NO、VEGF及PDGF-BB含量的影响[J].中华中医药杂志,2012,27(8):2048-2051.
[8] 冯锦,张瑛.真武汤合保元汤辅助西药治疗2型心肾综合征疗效及对ET-1、NO、炎性细胞因子水平的影响[J].中国中医急症,2019,28(1):119-122.DOI:10.3969/j.issn.1004-745X.2019.01.035.
[9] 阴文超,钱金桥.一氧化氮的心脏保护作用研究进展[J].国际麻醉学与复苏杂志,2019,40(2):185-189.DOI:10.3760/cma.j.issn.1673-4378.2019.02.018.
[10] WANG A,SI Z,XUE P,et al.Tacrolimus protects hippocampal neurons of rats with status epilepticus through suppressing oxidative stress and inhibiting mitochondrial pathway of apoptosis[J].Brain research,2019,1715:176-181.DOI:10.1016/j.brainres.2019.02.031.
[11] 加娜提.高同型半胱氨酸血症对大鼠血管内皮功能的影响[D].乌鲁木齐:新疆医科大学,2007:1-42.
[12] DAWSON T M,DAWSON V L,SNYDER S H,et al.A novel neuronal messengermolecular in brain:the free redi cal nitric oxide[J].Ann Neurol,1992,32(3):297.
[13] MCGULLAN L P,LEUMG G K,MARSDEN T A,et al.Hypoxia inhibits expression of eNOS via transcriptional,posttranscriptional mechanisms[J].Am J Physiol,1994,266(5):1921.
[14] 朱慧颖,彭红芬,陈玲,等.脑梗死后脑微出血影响因素分析[J].实用预防医学,2018,25(5):583-585.DOI:10.3969/j.issn.1006-3110.2018.05.019.
[15] 莉玲,余小金,闵捷,等.ROC曲线在医学诊断中的应用与进展[J].东南大学学报(医学版),2003,22(1):67-70.DOI:10.3969/j.issn.1671-6264.2003.01.025.