| Object To detect the levels of PECAM-1 and P-selectin expressed by platelets in patients with acute cerebral infarction(ACI) at serial time points, to observe relations between expression of PECAM-1 , P-selectin and cerebral infarction volumes, and relations between expression of PECAM-1 , P-selectin in patients with and without vascular risk factors, so as to research the clinical significance of expression of PECAM-1, P-selectin in ACI patients. At the same time to observe the effect of Sorium Ozagrel on ACI and on expression of PECAM-1, P-selectin by platelets in ACI patients.Methods 68 ACI inpatients of Neurology Department of Shandong Provincal Hospital from Nov. 2003 to Nov. 2004 were enrolled as ACI group, the criterions: (1) conform to the diagnosis criterions revised by the 4th Cerebralvascular Disease Conference; (2) verified by cranial CT or MRI scan; (3)within 48h after the onset: (4)excluding inflammatory or infection disease, cancer, severe liver disease, renal failure, or self immune disease; (5) without antiplatelet therapy within the last 2 weeks. The 68 patients were divided into 2 groups randomly: (1) common therapy group(n=35) (2)Sodium Ozagrel therapy group(n=33). Selected 38 outpatients withhypertension, type 2 diabetes mellitus, smoking, hyperlipoidemia during the same period as risk factors group,all these outpatients were excluded cerebral infarction by cranial CT or MRI scan.30 healthy people without cerebral infarction or risk factors were enrolled as normal controls. Vein blood samples 2ml were taken from ACI common therapy groups within 48 hours, and on days 5, 7, 14 after stroke onset, from ACI Ozagrel therapy groups within 48 hours, and on days 7, 14 after onset. Platelet PECAM-1 and P-selectin was detected by whole blood flow cytometry. Measurement were performed once in both risk factors and normal control groups by flow cytometry. ACI Patients were given scores of nervous functional deficiency and Barthel index before treated and on days 7, 14 after treated.Results The results showed significantly increase of platelets PECAM-1 and P-selectin within 48 hours after stroke onset as compared with risk factors group and normal controls, PO.001. Then the expression levels declined. On day 14 , expression level of PECAM-1 was still significantly higher than that of normal controls, PO.01; and expression level of P-selectin was higher than ,but near to, that of normal controls (PO.05). For ACI patients, the expression levels of P-selectin in patients with hypertension or diabetes were higher than those of patients without hypertension or diabetes, P<0.01; there were no differences between those of ACI with and without hyperlipoidemia or smoking(P>0.05); the expression levels of PECAM-1 had no difference between ACI with risk factors and ACI without risk factors. The expression level of PECAM-1 at 48 hours had positive correlation with the sizes of cerebral infarction (r=0.39, PO.05) ,and had no relation with scores of nervous functional deficiency (r=0.18, P>0.05) ; The expression level of P-selectin had positive correlation with the sizes of cerebral infarction and scores of nervous functional deficiency( r=0.63, P<0.01;r=0.47, PO.01 respectively). On day 14, the scores of nervous functional deficiency were passively correlated with the expression levels of PECAM-1( r=-0.43, PO.05), but not P-seletin. On days 7, 14 after Ozagrel treatment , the scores of nervous functional deficiency and Barthel index improved significantly compared to common therapy groups; the levels of PECAM-1 declined more slowly, while the level of P-seletin declined more faster, than those of commontherapy.Conclusion Expression levels of platelets PEC AM-1 and P-selectin increased significantly in ACI patients, and were correlation with degree of the lesions; Ozagrel treatment could accelerate the decline of P-selectin expression and decelerate the decline of PEC AM-1 expression; Ozagrel treatment could alleviate the degree of nervous functional deficiency and the disability of ACI patients.
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