血清可溶性细胞间黏附分子-1与重症肺炎的关系研究

Relationship between soluble intercellular adhesion molecule-1 and severe pneumonia

摘要:

目的：血清可溶性细胞间黏附分子-1（sICAM-1）是人体内重要的细胞表面黏附分子，参与机体众多的免疫反应及炎症反应，但其在重症肺炎患儿中的表达情况，以及与重症肺炎的关系，则未见系统的研究。该研究探讨血清sICAM-1在重症肺炎发病过程中的变化及其与重症肺炎的关系。方法：采用双抗体夹心酶联免疫吸附法测定50例重症肺炎患儿和56例普通肺炎患儿不同病程中的血清sICAM-1水平，以及52例健康对照组小儿血清sICAM-1水平。结果：重症肺炎急性期血清sICAM-1为402.36±31.24 μg/L，明显高于其恢复期水平的198.56±12.63 μg/L，差异具有显著性(P<0.01),与普通肺炎急性期的278.86±36.24 μg/L及健康对照组 180.74±21.46 μg/L比较，差异亦有显著性(P<0.01)；重症肺炎恢复期血清sICAM-1水平与普通肺炎恢复期的193.42±23.65 μg/L及健康对照组比较，则差异无显著性（P >0.05）；重症细菌性肺炎、病毒性肺炎、支原体（MP）肺炎、病毒与细菌混合感染性肺炎急性期血清sICAM-1分别为412.15±18.36 μg/L、386.25±31.62 μg/L、398.41±16.83 μg/L、389.76±24.88 μg/L，差异均无显著性（P>0.05）；重症肺炎经治疗后痊愈病例及好转病例急性期血清sICAM-1分别为396.18±22.31 μg/L，392.79±37.43 μg/L，差异也无显著性（P >0.05）。结论：sICAM-1可能参与了重症肺炎的炎症过程，其水平变化可以作为重症肺炎的诊断及病情轻重的判断指标之一。［中国当代儿科杂志，2007，9（6）：537-539］

Abstract:

OBJECTIVE: It has been reported that soluble intercellular adhesion molecule-1 (sICAM-1) participates in many immune and inflammatory reactions. Its expression and role in severe pneumonia has not fully been understood. This study aimed to investigate the changes of sICAM-1 expression in severe pneumonia and the relationship between sICAM-1 and severe pneumonia in children. METHODS: Serum sICAM-1 levels were determined by the double antibody sand using ELISA in 50 children with severe pneumonia and 56 children with mild pneumonia. Fifty-two healthy children served as control group. RESULTS: Serum sICAM-1 levels in children with severe pneumonia （402.36±31.24 μg/L）were remarkably higher than those in the mild pneumonia group (278.86±36.24 μg/L) at the acute stage and higher than in the control group (180.74±21.46 μg/L) (P<0.01). Serum sICAM-1 levels in children with severe pneumonia decreased significantly at the recovery stage (198.56±12.63 μg/L) (P<0.01), which were not statistically different from those in the mild pneumonia group at the recovery stage and the control group. There were no significant differences in serum sICAM-1 levels among the severe pneumonia subgroups caused by different pathogens (bacteria,virus or Mycoplasma) at the acute stage. Serum sICAM-1 levels at the acute stage in children with severe pneumonia who were treated successfully were not significantly different from those in patients whose symptoms were partly improved. Conclusions sICAM-1 might be involved in the inflammation course of severe pneumonia. It can severe as a marker of the diagnosis and the severity evaluation of severe pneumonia.［Chin J Contemp Pediatr, 2007, 9 (6):537-539］