高压氧干预下急性脑梗死患者CD11及CD54变化及其对预后的影响  

Changes of CDll,CD54 in patients with acute cerebral infarction after hyperbaric oxygen intervention and theirinfluence on patients＇prognosis

作　　者：李雁[1] 黄烽[1] 韩涛[1] 蔡鹏威[2] 陈发林[2] 周宝英[1] 林侃[1] 张天强[1] 

机构地区：[1]福建省立医院省心血管病研究所高压氧室,福州350001 [2]福建省立医院省心血管病研究所检验科

出　　处：《中华物理医学与康复杂志》2011年第5期362-366,共5页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：福建省科技开发计划项目，福建省卫生厅青年科研基金

摘　　要：目的探讨高压氧干预下急性脑梗死（ACI）患者CD11和CD54变化及其对预后影响。方法将ACI患者64例分为对照组33例和高压氧治疗组（高压氧组）31例。对照组行常规治疗，高压氧组行常规治疗并高压氧治疗。2组患者均在发病≤72h及发病第7，10，12和20天晨抽取外周静脉血测定CD11a、CD11c和CD54，并在相同发病时间采用神经功能缺损程度评分（NDS）。另外选取健康者25例作为正常对照，仅抽取周围静脉血测定CD11a、CD11c和CD54。结果高压氧组和对照组在发病≤72h时CD11a、CD11c和CD54表达达到高峰，2组之间各指标差异不显著，第7天都开始呈现下降趋势。高压氧组CD11a、CD11C高峰持续时间7d，对照组持续10d；CD54高峰持续时间高压氧组为10d，对照组为12d。经相关和线性回归分析发现，发病第20天时NDS的水平（近期疗效）和发病半年、1年时NDS的水平（远期疗效）分别有97．3％、96．7％及96．6％可用发病前CD11a和／或CD11e和／或CD54的水平以及其他相关因素解释。结论高压氧治疗可缩短ACI患者CD11a、CD11c和CD54高峰维持时间。高压氧可干预细胞黏附分子的变化过程，缩短异常时限，减少它们的表达，对ACI患者有保护作用。同13j治疗前CD11a、CD11c和CD54的表达可预测病情的轻重，影响近远期疗效，预测预后。Objective To observe the changes of CD11a, CD11c and CD54 and its＇influence on prognosis after the intervention of hyperbaric oxygen（HBO） in patients with acute cerebral infarction （ACI）. Methods Sixty-four ACI patients were divided into control group（C group） and HBO therapy group（ HBOT group）. C group （33 cases） received routine treatment only, HBOT group （31 cases） received routine treatment and hyperbaric oxygen therapy. CD11a, CD11c and CD54 were measured in both groups at 〈≤72h, the 7th d, 10th d, 12th d, 20th d after ACI, and neural functional damage scores（NDS） were evaluated at the same time. CDlla, CDllc and CD54 were also measured in normal control group （25 cases）. Results Plasma levels of CDlla, CDIle and CD54 rose significantly both in HBOT group and C group and peaked ate≤72 h after ACI, there was no significant difference between two groups （P 〉 0.05 ） , then declined at the 7th d. Levels of CDlla, and CDllc maintained at the peak for7 d in HBOT group and for 10 d in C group. CD54 peak remained for 10 d in HBOT group, and for 12 d in C group. A correlation analysis and linear regression analysis showed that the NDS levels at 20th d （ short-term curative effect） , 6 months and 12 months （ long-term outcome） could be explained by 97.3% , 96.7% and 96.6% , respectively by the admission levels of CD11 a and/or CD11 c and/or CD54 and other related factors. Conclusion After hyperbaric oxygen therapy peak level duration of CDlla, CDllc and CD54 could be shortened. Hyperbaric oxygen could influence intercellular adhesion molecule changing process, reduce leukocytes adhesion, decrease expressions of CDlla CDllc and CD54, and protect ACI patients. Before treatment, expression of CD11a, CD11c and CD54 may predict the severity, short or long-term outcome and prognosis of ACI patients.

关 键 词：CD11 CD54 高压氧治疗 急性脑梗死 神经功能恢复 

分 类 号：R743.3[医药卫生—神经病学与精神病学]