急性脑出血患者血清CD40、ICAM-1水平变化及临床意义

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摘要目的研究急性脑出血患者血清CD40、细胞间黏附分子-1（ICAM-1）表达变化及临床意义。方法选取2017年1月～2019年1月湖南省郴州市第一人民医院（以下简称“我院”）诊治的153例急性脑出血患者作为病例组，选择我院健康体检者60名作为对照组。根据不同预后将病例组患者分为死亡亚组40例、预后良好亚组68例和预后不良亚组45例。应用酶联免疫吸附试验（ELISA）检测两组血清中CD40及ICAM-1表达，分析组间表达差异及两指标与临床特征和预后的关系。结果病例组血清CD40、ICAM-1高于对照组，差异有统计学意义（P ＜ 0.05）。病例组血清CD40与ICAM-1呈显著正相关（r = 0.679，P = 0.000）。病例组不同脑出血量、神经缺损严重程度患者血清CD40及ICAM-1差异有统计学意义（P ＜ 0.05）。死亡亚组患者血清CD40、ICAM-1表达明显高于预后良好亚组及预后不良亚组，预后不良亚组血清CD40、ICAM-1表达高于预后良好亚组，差异有统计学意义（P ＜ 0.05）。结论急性脑出血患者血清中CD40及ICAM-1表达升高，与患者神经功能及预后密切有关，监测两指标有助于判断急性脑出血患者病情及预后。

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	全宏娟夏明万张圣岸

关键词 ：急性脑出血, CD40, 细胞间黏附分子-1, 预后

Abstract：Objective To study the changes and clinical significance of serum CD40 and intercellular adhesion molecule-1 (ICAM-1) expression in patients with acute cerebral hemorrhage. Methods From January 2017 to January 2019, a total of 153 patients with acute cerebral hemorrhage diagnosed and treated in Chenzhou First People′s Hospital, Hu′nan Province (hereinafter referred to as “our hospital”) were selected as the case group, and 60 healthy physical examinees in our hospital were selected as the control group. According to different prognosis, patients in the case group were divided into 40 cases in death subgroups, 68 cases in good prognosis subgroups and 45 cases in poor prognosis subgroups. CD40 and ICAM-1 expression in serum of two groups were detected by enzyme-linked immunosorbent assay (ELISA). The expression difference between groups and the relationship between the two indexes and clinical characteristics and prognosis were analyzed. Results The expressions of serum CD40 and ICAM-1 in the case group were higher than those in the control group, and the differences were statistically significant (P ＜ 0.05). The expressions of serum CD40 and ICAM-1 in the case group were significantly positively correlated (r = 0.679, P = 0.000). There were significant differences in serum CD40 and ICAM-1 in patients with different cerebral hemorrhage volume and severity of nerve defect (P ＜ 0.05). The expressions of CD40 and ICAM-1 in the death subgroup were significantly higher than those in the good and poor prognosis subgroups, the expressions of serum CD40 and ICAM-1 in the poor prognosis subgroup were significantly higher than those in the good prognosis subgroup, and the differences were statistically significant (P ＜ 0.05). Conclusion The expressions of CD40 and ICAM-1 in the serum of patients with acute cerebral hemorrhage are elevated, they are closely related to the neurological function and prognosis of patients. Monitoring the two indexes is helpful to judge the condition and prognosis of patients with acute cerebral hemorrhage.

Key words： Acute cerebral hemorrhage CD40 Intercellular adhesion molecule-1 Prognosis

基金资助:湖南省科技创新计划项目（2016JJ0107）。

通讯作者: 夏明万（1971.5-），男，主任医师，主要从事神经病学的研究。

作者简介: 全宏娟（1985.5-），女，硕士，主要从事脑血管病方向的研究。

引用本文:

全宏娟夏明万张圣岸. 急性脑出血患者血清CD40、ICAM-1水平变化及临床意义[J]. 中国医药导报, 2020, 17(20): 13-16,20.
QUAN Hongjuan XIA Mingwan ZHANG Sheng′an. Changes and clinical significance of serum CD40 and ICAM-1 levels in patients with acute cerebral hemorrhage. 中国医药导报, 2020, 17(20): 13-16,20.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2020/V17/I20/13

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