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①目的 探讨急性脑梗死(ACI)病人白细胞流变特性及细胞黏附分子表达的变化及意义。②方法采用红细胞变形能力测定仪、体外血栓血小板黏附两用仪及酶联免疫吸附法(ELISA),检测了72 例ACI病人、42例脑出血病人及48 例健康人白细胞变形能力(LD)、白细胞黏附功能(LAF)、白细胞CD18 表达及血清可溶性细胞间黏附分子-1(sICAM-1)和可溶性血管细胞间黏附分子(sVCAM-1)浓度的变化。③结果 ACI病人白细胞滤过指数(LFI)、白细胞黏附率(LAR)、白细胞CD18表达及sICAM-1 及sVCAM-1 浓度均明显升高,与脑出血病人及对照组比较差异有极显著性(t= 7.663~14.872,P< 0.001),且这些指标变化随着ACI病变程度加重而明显。ACI病人LFI和LAR与白细胞CD18 表达、sICAM-1 和sVCAM-1 浓度呈正相关(r= 0.680~0.724,P均< 0.001),LFI与LAR呈正相关(r= 0.685,P< 0.001)。④结论 白细胞流变特性和细胞黏附分子表达异常与ACI发病和病变程度有密切关系
①Objective To investigate the changes and significance of leukocyte rheology and expression of cell adhesion molecules in patients with acute cerebral infarction (ACI). Methods The erythrocyte deformability meter, thrombus platelet adhesion meter and enzyme - linked immunosorbent assay (ELISA) were used to detect the leukocyte deformability (LD) in 72 patients with ACI, 42 patients with cerebral hemorrhage and 48 healthy controls. Leukocyte adhesion function (LAF), leucocyte CD18 expression and changes of serum soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule (sVCAM-1) concentrations. ③ Results The leukocyte filtration index (LFI), leucocyte adhesion rate (LAR), leukocyte CD18 expression and the concentrations of sICAM-1 and sVCAM-1 in ACI patients were significantly higher than those in ICH patients and controls t = 7.663 ~ 14.872, P <0.001), and the changes of these indicators with the severity of ACI lesions significantly. LFI and LAR were positively correlated with leukocyte CD18, sICAM-1 and sVCAM-1 in patients with ACI (r = 0.680-0.724, P <0.001), and LFI was positively correlated with LAR (r = 0.685 , P <0.001). ④ Conclusion Leukocyte rheology and abnormal expression of cell adhesion molecules are closely related to the incidence and severity of ACI