Variations And Early Prediction Of Von Willebrand Factor And Soluble Intercellular Adhesion Molecule 1 In Acute Respiratory Distress Syndrome

Objective: To measure the plasma levels of vWF and sICAM-1 in patients at riskfor the development of ARDS and evaluate the significance of them in early diagnosis and prognosis of ARDS.Methods: Plasma vWF and sICAM-1 were both measured with ELISA in patientsat risk but not development of ARDS group (15 cases) and ARDS group (20 cases) on admission to hospital and on the day 2,3,5,7 respectively.Results: Plasma levels of vWF and sICAM-1 were markedly higher in ARDSgroup and non-ARDS group than in control group (p<0.001). A statistically significant difference occurred in the mean vWF level for ARDS and non-ARDS patients at the first three time points (p<0.05). And the sICAM-1 levels between the two groups at the first four time points existed statistical significant difference (p<0.05). The counts of activated neutrophil were higher in ARDS group and non-ARDS group than in control group (p<0.001), and at the first four time points the counts of ARDS group were significantly greater than those in non-ARDS group (p<0.05). The levels of the two markers were both higher in MODS group than without MODS group (p<0.05). There was a positive correlation between plasma levels of vWF and sICAM-l(r=0.599, p<0.01).Conclusion: Plasma levels of vWF and sICAM-1 and the counts of activatedneutrophil elevated in early ARDS. These observations suggest that there are activation and injury of endothelium and neutrophil in early ARDS. The adhesion interaction among endothelium, neutrophil and platelet increased.