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BACKGROUND:

Pro-inflammatory cytokines can promote the expression nof intercellular adhesion molecule-1 (ICAM-1), and the adhesion of white cells to intravascular endothelium, thereby involving in the developing ischemic stroke.

OBJECTIVE:

To investigate the prognostic value of soluble intercellular adhesion molecule-1 (sICAM-1) and its relative factors in the developing ischemic stroke.

DESIGN:

Randomized controlled study based on patients.

SETTING:

Department of neurology, the field surgery research institute in a military hospital of Chinese PLA.

PARTICIPANTS:

Between January 1st and December 31st 2000, total 238patients with ischemic stroke received treatment at the Neurological Department of the Third Affiliated Hospital, the Third Military Medical University of Chinese PLA, including 117 males and 121 females, amongst which 186cases were confirmed of none-developing ischemic stroke and 52 cases developing ischemic stroke.

INTERVENTIONS:

After hospitalization, patients were subject to daily neurological examination, Canada stroke score(CSS), temperature and white blood cell(WBC) counting, sICAM was examined at 1, 3 and 7 days after hospitalization.correlative factors between developing ischemic stroke and non-developing ischemic stroke at 24 hours 3 days and 7 days after the onset of stroke.

RESULTS:

Within 24 hours from the onset of stroke, the number of WBC was[(8.4 ± 1.2) × 109 L-1] in developing ischemic stroke group, with blood glucose of[ (45.8 ± 5.1) g/L], fibrinogen of[ (64. 6 ± 5. 1) g/L] and sICAM-1 of[ (261.4 ± 9. 7) μg/L], which were obviously higher than the corresponding[(6.7±1.3) ×109 L-1, (36.2±5.5) g/L, (44.0±6.2) g/L,(223. 1 ± 8.4) μg/L] in non-developing ischemic stroke group, the difference was of statistical significance( t = 2. 368 - 2. 387, P ＜ 0. 01 ) . The results of multiple factor analysis on developing ischemic stroke indicated that serum sICAM-1 was a risk factor independent of higher blood glucose,fibrinogen and CSS, and was obviously correlated with developing ischemic stroke( OR =2.9, 95% CI= 1.4 -6. 3) . There was significant change in sICAM-1, the number of WBC, blood glucose and fibrinogen at 24 hours, 3days and 7 days, as well as the scores for CSS at hospitalization in developing ischemic stroke group, which were significantly different from non-developing ischemic group( t = 2. 345 - 2. 878, P ＜ 0.01 ).

CONCLUSION:

sICAM-1 was proved obviously correlated with developing ischemic stroke, and can be used as a prognostic factor.