| 1. BackgroundCoronary atherosclerotic disease (CAD) is a common disease of cardiovascular system. It now has been one of the main diseases which hazard human in the world. The inflammatory reaction induced by cellular adhesion molecules plays an early and crucial role in the development and progression of atherosclerosis (AS) and restenosis after percutaneous transluminal coronary angioplasty (PICA). Cellular adhesion molecules induce the adhesion between leucocytes and vascular endothelial cells, then facilitate the formation of atherosclerotic plaque. The overexpression of cellular adhesion molecules may play an important role in the pathogenesis of AS and CAD. It was reported that the monoclonal antibody of ICAM-1 could effectively inhibit the formation of atherosclerotic plaque in animal experiment. But there were few clinical report about cellular adhesion molecules in patients with CAD and the effect of PTCA on the level ofcellular adhesion molecules.2. ObjectiveTo explore the significance of cellular adhesion molecules in coronary atherosclerotic disease (CAD) by measuring serum soluble intercellular adhesion molecule-1 (sICAM-1) and P-selectin (Ps) levels in patients with CAD. To study the effects of percutaneous transluminal coronary angioplasty (PTCA) on serum sICAM-1 and Ps in patients with coronary?atherosclerotic disease.3. Method(1) By means of enzyme linked immunosorbent assay (ELISA),the concentrations of serum sICAM-1 and Ps were measured in 68 . patients with CAD as well as in 55 controls. Determinative histochemistry for enzymes was used to detect the concentrations of fasting plasma triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-ch) and low density lipoprotein cholesterol (LDL-ch).(2) The Gensini scoring system was used to determine the severity of coronary artery lesions. The concentrations of serum sICAM-1 and Ps in CAD patients with different severity of coronary artery lesions were observed.(3) The correlations between age, body mass index, sex, smoking, hypertension, celluar adhesion molecules, TG, TC, HDL-ch, LDL-ch and the severity of coronary artery lesions wereanalyzed. Study the effects of lipid on the concentrations of serum sICAM-1 and Ps in CAD patients.(4) Sixty seven patients underwent coronary angiography (CAG) were divided into PICA group (n=22, CAG+ following PICA), CAG+ group (n-20, CAG+ without PICA) and CAG- group (n=25).The two latter groups served as positive and negative controls respectively. The effect of PICA on sICAM-1 and Ps in coronary sinus (Cs) and peripheral vein (Pv) blood was observed. 4. Result(1) The concentrations of sICAM-1 and Ps were significantly higher in CAD patients than those in controls (both /<0. 001). The level of HDL-ch in CAD patients was lower than that in controls (RO. 01), and LDL-ch was obviously higher (KO. 01).(2) In CAD patients with different Gensini score, the concentration of serum sICAM-1 was different (/<0. 001). The level of Ps in CAD patients was not significantly different (P>0. 05).(3) A significant correlation between the severity of the coronary artery lesions and the levels of serum sICAM-1 and total cholesterol (TC) was found from the multiple regression analysis(KO. 001 and RO. 01). The concentration of triglyceride (TG) may influence the level of serum sICAM-1 (r=0. 403,/<0. 01).(4) In PTCA group and CAG+ group, the levels of sICAM-1 andPs in Pv were all higher than those of CAG- group (y O. 01).In PICA group , the levels of sICAM-1 15min, 30min after PICA in Cs and 24h, 48h after it in Pv were higher than those before PICA (/KO. 05). The Ps levels in Cs increased immediately (5min) after PICA and reached the peak 15min after it, while in Pv the peak time was delayed to 24h after it. 5. Conclusion(1) ICAM-1 and Ps may involve in the pathogenesis of coronary atherosclerotic disease.(2) Serum sICAM-1 might be an available index for the severity of CAD.(3) TG may be one of the factors which can inf...
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