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目的：观察急性心肌梗死（ＡＭＩ）患者接受再灌注治疗后，血清可溶性血管细胞粘附分子－１（ＶＣＡＭ－１）和Ｅ－选择素（Ｅ－Ｓ）水平的动态变化。方法：ＡＭＩ组患者２１例，随机接受直接ＰＴＣＡ或溶栓治疗，于再灌注治疗前、及治疗后４、８、１２、２４、４８、７２小时各抽血一次。不稳定型心绞痛患者１６例，对照组１６例各抽血一次。用双抗体夹心ＥＬＩＳＡ法测定ＶＣＡＭ－１和Ｅ－Ｓ。结果：１．ＡＭＩ组和不稳定型心绞痛组ＶＣＡＭ－１测值分别为９３６．７±１９６．８ｎｇ／ｍｌ和８２８．１±１７３．６ｎｇ／ｍｌ，均显著高于对照组６１１．４±７４．６ｎｇ／ｍｌ（Ｐ＜０．０１），Ｅ－Ｓ测值分别为５６．０±８．８ｎｇ／ｍｌ和５８．７±９．５ｎｇ／ｍｌ，均显著高于对照组４４．９±６．２ｎｇ／ｍｌ（Ｐ＜０．０５）。２．ＡＭＩ组中１６例接受再灌注治疗成功患者ＶＣＡＭ－１于２４、７２小时显著降低（Ｐ＜０．０５），Ｅ－Ｓ于２４、４８小时显著降低（Ｐ＜０．０５）。但治疗后４小时，Ｅ－Ｓ出现一增高峰，而再灌注治疗不成功者（ｎ＝５）未见高峰出现。３．冠脉病变支数与该两种粘附分子测值无相关性。结论：ＡＭＩ再灌注治疗可降低增高的血清粘附分子；其早期高峰的出现?
Objective: To observe the dynamic changes of serum soluble vascular cell adhesion molecule-1 (VCAM-1) and E-selectin (E-S) levels after acute myocardial infarction (AMI) Methods: Twenty - one AMI patients were randomized to receive either direct PTCA or thrombolytic therapy. Blood samples were taken at 4, 8, 12, 24, 48 and 72 hours after reperfusion. 16 patients with unstable angina pectoris and 16 patients in control group were drawn blood once. VCAM-1 and E-S were measured by double antibody sandwich ELISA. Results: 1. The values of VCAM-1 in AMI group and unstable angina group were 936.7 ± 196.8ng / ml and 828.1 ± 173.6ng / ml, respectively, which were significantly higher than that of control group 611.4 ± 74.6ng / ml (P <0.01). The E-S values were 56.0 ± 8.8ng / ml and 58.7 ± 9.5ng / ml respectively, which were significantly higher than those in the control group 44.9 ± 6.2ng / ml (P <0.05). 2. In the AMI group, VCAM-1 was significantly decreased in 24 and 72 hours (P <0.05) and E-S in 24 and 48 hours after reperfusion were significantly decreased (P <0.05). However, there was an increase in E-S peak 4 hours after treatment, but no peak appeared in those who failed to be reperfused (n = 5). 3. There was no correlation between the number of coronary lesions and the two adhesion molecules. Conclusion: AMI reperfusion therapy can reduce the increased serum adhesion molecules; the emergence of its early peak?