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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 expression of intercellular adhesion molecule-1 (ICAM-1), endothelin-1 (ET-1) in patients with cerebral infarction Level changes and clinical significance. Methods A total of 110 patients with acute cerebral infarction who were first attacked from January 2011 to August 2011 in the General Hospital of Nanjing Military Region were selected and all patients underwent routine sequential magnetic resonance imaging and susceptibility weighted imaging (SWI) within 7 days ). According to the performance of magnetic resonance imaging examination was divided into CMBs group and no CMB group, and according to the number of CMBs severity grading. Serum levels of ICAM-1 and ET-1 were measured at 2 months after stroke in patients. Results The ICAM-1 (332 ± 46.3) ng / ml and ET-1 levels (71.39 ± 12.7) ng / ml in 45 CMBs patients were significantly different from those in 65 CMBs patients (t = -2.703, P = 0.010; t = -3.815, P <0.001). The age, sex, history of hypertension, history of diabetes mellitus and smoking history were adjusted to find ICAM-1 odds ratio (OR) = 1.023,95% (OR = 1.070, 95% CI 1.012-1.1313, P = 0.018; r = 0.486, P <0.001) with CMBs (CI = 1.008-1.0838; P = 0.003; r = 0.406; Was positively correlated. Conclusion The levels of plasma ICAM1 and ET-1 in CMB patients during recovery from cerebral infarction were higher than those in CMB patients, and positively correlated with the severity of CMBs, suggesting that the endothelial function of CMBs was significantly impaired.