Bucek Robert A, Reiter Markus, Quehenberger Peter, Minar Erich, Baghestanian Mehrdad
University Clinic of Internal Medicine II, General Hospital, Vienna, Austria.
Blood Coagul Fibrinolysis. 2003 Oct;14(7):653-7. doi: 10.1097/00001721-200310000-00006.
Activation of the endothelium, platelets and leukocytes has been shown to play an important role in the aetiology of deep venous thrombosis (DVT) in in-vitro experiments, resulting in the release of soluble cell adhesion molecules (sCAMs). We therefore assessed the value of soluble intracellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble E-selectin and soluble P-selectin for the diagnostic process in 69 consecutive patients with suspected DVT. Final diagnosis was based on the results of Duplex sonography or ascending venography. Thirty-seven patients (53.6%) finally suffered from DVT. Mean levels of sVCAM-1 were 589 +/- 530 ng/ml for controls and 587 +/- 328 ng/ml for patients. Corresponding levels concerning sICAM-1 were 316 +/- 161 and 342 +/- 186 ng/ml, those concerning soluble E-selectin were 54 +/- 38 and 42 +/- 18 ng/ml, and those concerning soluble P-selectin were 94 +/- 37 and 99 +/- 36 ng/ml (all P > 0.05). There was no significant correlation of the thrombus extension (all P > 0.05) or the duration of symptoms with sCAMs (all P > 0.05). In conclusion, we detected no significant differences concerning the concentration of four major sCAMs between patients with DVT and controls, so their assessment does not add any useful information for the diagnostic process of DVT.
在体外实验中,内皮细胞、血小板和白细胞的激活已被证明在深静脉血栓形成(DVT)的病因学中起重要作用,导致可溶性细胞粘附分子(sCAMs)的释放。因此,我们评估了可溶性细胞间粘附分子-1(sICAM-1)、可溶性血管细胞粘附分子-1(sVCAM-1)、可溶性E-选择素和可溶性P-选择素在69例连续疑似DVT患者诊断过程中的价值。最终诊断基于双功超声或上行静脉造影的结果。37例患者(53.6%)最终患有DVT。对照组sVCAM-1的平均水平为589±530 ng/ml,患者为587±328 ng/ml。sICAM-1的相应水平分别为316±161和342±186 ng/ml,可溶性E-选择素的相应水平分别为54±38和42±18 ng/ml,可溶性P-选择素的相应水平分别为94±37和99±36 ng/ml(所有P>0.05)。血栓延伸(所有P>0.05)或症状持续时间与sCAMs均无显著相关性(所有P>0.05)。总之,我们发现DVT患者与对照组之间四种主要sCAMs的浓度无显著差异,因此它们的评估对DVT的诊断过程没有增加任何有用信息。