急性脑梗死超负荷血糖与细胞黏附分子-1相关性研究  

The correlation between hyperglycemia after acute cerebral infarction and the changes of serum intercellu- lar adhesion molecule-1

作　　者：赵晓晖[1] 顾承志[1] 黄怀宇[1] 

机构地区：[1]江苏省南通医学院第二附属医院神经内科,226001

出　　处：《中国脑血管病杂志》2004年第6期265-267,共3页Chinese Journal of Cerebrovascular Diseases

基　　金：江苏省卫生厅重点攻关课题(H200217)

摘　　要：目的 探讨脑梗死超负荷血糖与细胞间黏附分子-1(ICAM-1)的变化及其相关性。方法脑梗死患者87例,根据血糖水平分为正常血糖组(36例)、应激性高血糖组(27例)和糖尿病组(24例),分别于病程24 h、1周、2周与3周检测血清可溶性ICAM-1。结果 各组可溶性ICAM-1浓度在24 h均有明显增高,正常血糖组(495±29)μg／L,应激性高血糖组(790±27)μg／L,糖尿病组(698±38)μg／L;可溶性ICAM-1浓度1周时达高峰,正常血糖组(748±31)μg／L,应激性高血糖组(1027±35)μg／L,精尿病组(1142±39)μg／L;此后逐渐下降,应激性高血糖组、糖尿病组增高幅度更高,糖尿病组增高幅度最大、最持久。结论 脑梗死时ICAM-1在超负荷血糖条件下表达明显增强,并在脑梗死病理机制中发挥重要作用。控制脑梗死患者血糖及炎性反应,为脑血管病的防治开辟新的途径。Objective To study the correlation between hyperglycernia after- aeute cerebral infarction and the changes of serum intercellular adhesion molecule-1 (ICAM-1). Methods 87 patients with acute cerebral infarction were divided into three groups, namely, the normoglycaemic group, the stress hyperglycemic group and the diabetic group. The levels of serum soluble ICAM-1 (sICAM-1 ) were measured at the 24th hour, the first week, the second week and the third week after onset of cerebral infarction. Compared the levels of sICAM-1 of different groups at different intervals mentioned above and the trend of slCAM-1 at different intervals in each group. Results The levels of serum sICAM-1 in all groups increased at the 24th hour, the mean concentrations of serum sICAM-1 in different groups were (495 ±29)μg/L, (790 ± 27) μg/L, (698 ± 38)μg/L, respectively. The levels of serum sICAM-1 peaked in the first week at (748 ±31 )μg/L, (1 027 ±35)μg/L, (1 142 ± 39) μg/L., respectively, and gradually decreased. In the third week, the levels of sICAM-1 in the normal blood sugar group and the stress hyperglyeemie: group declined to near normal range, whereas, it remained high in the diabetic group. The increase of serum slCAM-1 in the stress hyperglyeemie group and the diabetic group were higher (versus normal blood sugar group at the 24th hour and first week, P < 0. 01 ). The increment were lasting and reached (787 ±35)μg/L at the third week in the diabetic: group. The levels of serum sICAM-1 were no significant difference between the stress hyperglyeemie: group and the normoglycaemc group at the second and the third week ( P > 0. 05). Conclusion The expression of ICAM-1 increases with hyperglycemia after acute cerebral infarction, which may play a significant role in the pathophysiology of acute cerebral infarction. Control the blood sugar and inflammatory reactions in patients suffered from acute cerebral infarction may provide a new route for prevention and treatment of certain cere brovasculat disease.

关 键 词：急性脑梗死 超负荷血糖 细胞黏附分子-1 1CAM-1 高血糖症 

分 类 号：R743.3[医药卫生—神经病学与精神病学]