急性脑梗死患者外周血CD34^＋细胞与血管内皮细胞生长因子动态变化及其临床意义

Dynamic changes in peripheral blood CD34^＋ cells and plasma VEGF levels in patients with acute cerebral infarction

目的 探讨血管内皮生长因子（VEGF）和CD34^＋细胞在急性脑梗死发病中的变化及作用关系。方法分别采取流式细胞仪及酶联免疫法（ELISA）动态测定40例急性脑梗死患者及正常对照者起病后或入组后第3、7、10、14天外周血CD34^＋细胞和血清VEGF水平，分析其关系。结果脑梗死组外周血CD34^＋细胞水平在各时间点均明显高于对照组，第10天达峰值；脑梗死患者血清VEGF浓度在各时间点亦明显高于对照组，第7～10天达峰值，差异有统计学意义（P〈0．05）；CD34^＋细胞水平与血清VEGF浓度两者存在正相关（r=0．452，P〈0．01）。结论脑梗死后外周血VEGF及CD34^＋细胞水平的升高将促进血管生成，改善脑组织缺血缺氧状态，起到保护神经功能的作用。

Objective To investigate the dynamic changes in peripheral blood CD34^＋ cells and plasma levels of vascular endothelial growth factor （VEGF） in patients with acute cerebral infarction, and explore the roles ofCD34^＋ cells and VEGF in acute cerebral infarction. Methods In 40 patients with acute cerebral infarction, the counts of CD34^＋ cells in the peripheral blood were measured using flow cytometry on days 3, 7, 10 and 14 following the onset, with 40 healthy individuals as the control. Plasma levels of VEGF were also measured in these subjects at the same time points using enzyme-linked immunoassay （ELISA）. Results Peripheral CD34^＋ cells increased significantly after the onset of acute cerebral infarction, reaching the peak level on day 10. Plasma VEGF levels also increased significantly in the patients as compared with that in the control subjects, reaching the peak level on days 7 to 10. An obvious correlation was noted between the levels of peripheral blood CD34^＋ cells and VEGF levels in the patients with acute cerebral infarction. Conclusion Increased peripheral VEGF level and CD34^＋ cells following acute cerebral infarction may promote angiogenesis, improve brain tissue hypoxia ischemia, and so play a role in the protection of nerve function.