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目的 探讨脑梗死患者白细胞流变特性和分子流变特性改变及其在脑缺血性损伤中的作用。方法 对62例急性脑梗死患者及 3 8名健康对照者外周血白细胞聚集性 (LA)、白细胞黏附功能 (LAF)和血清可溶性细胞间黏附分子 -1 (s ICAM-1 )、血管内皮细胞黏附分子 -1 (s VCAM-1 )浓度进行检测 ,根据头部 CT结果将脑梗死分成大面积脑梗死和中小面积脑梗死 ,同时对脑梗死患者神经功能缺损程度进行评分。结果 急性脑梗死患者LA、LAF和 s ICAM-1、s VCAM-1的浓度明显增高 ,与对照组比较差异有显著性 (P<0 .0 5 ) ;大面积脑梗死患者LA、LAF和 s ICAM-1、s VCAM-1的浓度均较中小面积脑梗死患者明显增高 ,差异有显著性 (P<0 .0 5 ) ;脑梗死患者神经功能缺损程度评分与 LA、LAF和 s ICAM-1、s VCAM-1呈正相关 (r=0 .3 3 77～ 0 .71 88,P<0 .0 5 ) ;LA和 LAF均与 s ICAM-1、s VCAM-1呈正相关 (r=0 .3 3 3 1～ 0 .5 865 ,P<0 .0 5 )。结论 急性脑梗死患者存在白细胞流变特性及分子流变特性的异常 ,这种异常在脑缺血和再灌注损伤中可能发挥重要作用。
Objective To investigate the changes of leukocyte rheology and molecular rheology in patients with cerebral infarction and its role in cerebral ischemic injury. Methods Peripheral blood leukocyte aggregation (LA), leukocyte adhesion function (LAF), s ICAM-1 and adhesion of vascular endothelial cells were measured in 62 patients with acute cerebral infarction and 38 healthy controls. 1 (s VCAM-1) were measured. The cerebral infarction was divided into large-area and small-area cerebral infarction according to the result of head CT. The degree of neurological deficit in patients with cerebral infarction was also scored. Results The concentrations of LA, LAF and ICAM-1, s VCAM-1 in patients with acute cerebral infarction were significantly higher than those in the control group (P <0.05). LA, LAF and s The levels of ICAM-1 and VCAM-1 in patients with cerebral infarction were significantly higher than those in middle-small area patients with cerebral infarction (P <0.05). The scores of neurological deficits in patients with cerebral infarction were significantly correlated with LA, LAF and ICAM-1 , S VCAM-1 was positively correlated (r = 0.3377 ~ 0.7188, P <0.05). LA and LAF were positively correlated with s ICAM-1, s VCAM-1 (r = 3 3 3 1 ~ 0 .5 865, P <0. 05). Conclusion There are abnormalities of leukocyte rheology and molecular rheology in patients with acute cerebral infarction. This abnormality may play an important role in cerebral ischemia and reperfusion injury.