老年慢性心力衰竭患者淋巴细胞细胞间黏附分子-1、血管细胞间黏附分子-1的表达及与心功能的关系探讨  

Relationship between the expression of intercellular adhesion molecule-1 and vascular cell adhesion molecule-1 on lymphocytes and cardiac function in elderly patients with chronic heart failure

作　　者：孟松艳[1] 于卫刚[1] 张一娜[1] 杨奕[1] 裴丽春[1] 

机构地区：[1]哈尔滨医科大学附属第二医院老年病科,150086

出　　处：《临床内科杂志》2015年第3期185-187,共3页Journal of Clinical Internal Medicine

摘　　要：目的：探讨老年慢性心力衰竭（简称心衰）患者淋巴细胞细胞间黏附分子-1（ICAM-1）、血管细胞间黏附分子-1（VCAM-1）水平与血红蛋白（Hb）的关系及与心室重构、心功能的关系。方法对入选的76例老年慢性心衰患者（心衰组）行实验室和超声心动图检查，按 Hb水平又分为贫血组（27例）和非贫血组（49例）；并进行心功能分级。同时选择25例同期健康体检老年人为对照组，比较各组间淋巴细胞 ICAM-1、VCAM-1、Hb 、左室射血分数（LVEF）、左心室质量指数（LVMI）和平均室壁应力（MWS）。结果与对照组比较，心衰组患者 ICAM-1、VCAM-1和LVMI、MWS 明显升高，Hb 和 LVEF 降低（P ＜0．01），随着心功能恶化，淋巴细胞 ICAM-1和 VCAM-1的水平以及 LVMI 和 MWS 逐渐升高，而 Hb 水平则逐渐降低；心衰贫血组患者淋巴细胞 ICAM-1和VCAM-1的水平以及 LVMI 和 MWS 明显高于非贫血组（P ＜0．05）；心衰患者淋巴细胞 ICAM-1和VCAM-1的水平与 LVMI 和 MWS 均呈正相关（P ＜0．01）。结论心衰患者淋巴细胞 ICAM-1和VCAM-1水平升高和 Hb 水平的降低参与了心功能不全、心室重构发生发展的病理生理过程。Objective To study the change of intercellular adhesion molecule-1 （ICAM-1）and vascular cell adhesion molecule-1（VCAM-1）and the possible association between ICAM-1,VCAM-1 and hemoglobin（Hb）,and their effects on left ventricular mass index（LVMI）,mean wall stress（MWS）and cardiac function in elderly patients with chronic heart failure （CHF）.Methods 76 inpatients with chronic cardiac failure were selected in the study.The patients were classified with NYHA-class,and were divided into anemia group and non-anemia group according to hemoglobin （Hb）level.25 healthy old persons were selected as control group.Levels of ICAM-1,VCAM-1,and Hb were measured.Left ventricu-lar ejection fraction（LVEF）was determined by echocardiography,and left ventricular mass index（LVMI）, mean wall stress （MWS） were calculated.Those data were compared between 2 groups.Results Compared with control group,the levels of ICAM-1,VCAM-1,LVMI and MWS in patients with CHF were increased,and the levels of Hb and LVEF were decreased（P 〈0.01 ）.The levels of ICAM-1,VCAM-1 and LVMI、MWS significantly increased with the increase of severity degree of cardiac function.The levels of ICAM-1,VCAM-1 and LVMI,MWS in the anemia group were higher than those in the non-anemia group subjects.There were positive correlation between the levels of ICAM-1,VCAM-1 and LVMI,MWS （P 〈0.01 ）,negative correlation was existed between LVMI,MWS and Hb concentration and LVEF （P 〈0.01）.Conclusion Increase of the levels of ICAM-1,VCAM-1 and the decrease of the level of Hb in patients with CHF play pathophysiological and pathogenetic roles in mechanism of ventricular remodeling and associate with the severity degree of ventricular remodeling

关 键 词：心力衰竭 细胞间黏附分子-1 血管细胞间黏附分子-1 贫血 心室重构 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]