目的 探讨心肺复苏后存活48 h以上患者血清可溶性细胞间黏附分子( sICAM-1)、可溶性血管细胞黏附分子( sVCAM-1)、可溶性E-选择素( sE-selectin)变化特点及其临床意义。方法 对非感染因素心脏骤停行心肺复苏后存活48 h以上的患者， 测定复苏前、复苏后1、4、8、12、48 h血清sICAM-1、sVCAM-1、sE-selectin水平， 比较各时段变化差异。结果 复苏后12 h之前， 血清sICAM-1、sVCAM-1、sE-selectin水平呈现逐渐增高趋势， 各时段差异有统计学意义( P<0.01);而在复苏后24 h， 除sICAM-1、sE-selectin持续升高外， sVCAM-1出现降低( P<0.01);在复苏后48 h， sICAM-1、sVCAM-1也呈现缓慢或显著降低态势， 而sE-selectin却持续有意义走高( P<0.01)。结论 心肺复苏后恢复自主循环使组织得到一定灌注， 但血管内皮的损伤依然未终止， 组织器官的功能进一步衰化。

Objective To study serum soluble intercellular adhesion molecule ( sICAM-1), soluble vascular cell adhesion molecule ( sVCAM-1), soluble E-select the element ( sE-selectin) changes in 28 patients surviving more than 48 hours after cardiopulmonary resuscitation ( CPR). Methods By using the method of randomized controlled studies after cardiopulmonary resuscitation ( CPR) , noninfectious factors of sudden cardiac arrest patients survived more than 48 hours in 28 cases, using the double antibody enzyme-linked immunosorbent method to determine recovery before each period after recovery, the serum average change levels of sICAM-1, sVCAM-1, sE-selectin were compared with the time change difference. Results Before 12 hours after recovery, serum sVCAM-1 sICAM-1 and sE-selectin levels showed a trend of gradually increasing over time, and in the recovery after 24 hours except sICAM-1, sE-selectin continued to rise, sVCAM-1 significantly reduced, 48 hours after recovery, sICAM-1 sVCAM-1 also slowed or significantly reduced, and sE-selectin significantly. Conclusions Serum sVCAM-1, sICAM-1 and sE-selectin levels in each period after recovery remain high and rising although spontaneous circulation after certain perfusion is verified, and vascular endothelial injury is still not terminated, tissue and organ functions further fail.