脑梗死患者外周血CD34^＋细胞水平和预后价值

Level and prognostic value of circulating CD34^＋ cell in palients with acute ischemic stroke

目的检测首发非腔隙性脑梗死患者体内CD34^＋细胞水平的变化，探讨外周血CD34^＋细胞水平的预后价值。方法采用流式细胞仪测定119例非腔隙性脑梗死患者外周血CD34^＋细胞水平，根据检测值分为高于平均值组（A组）和低于平均值组（B组），比较两组人院时美国国立卫生研究卒中量表（National Institutes of Health Stroke Scale，NIHSS）评分和发病3个月时改良Rankin量表（modified Rallkin Scale，mRS）评分。结果人院时，A组CD34^＋细胞水平显著高于B组（0．048±0．001对0．032±0．002，P〈0．05），但NIHSS评分无显著差异（17．51±5．33分对17．64±5．19分）。入院1周后，A组CD34^＋细胞水平增加值显著高于B组（0．001±0．003对-0．005±0．0001，P〈0．05）。3个月时A组mRS评分显著优于B组（2．98±1．14分对3．25±1．39分，P〈0．05）。相关性研究显示，发病初期CD34^＋细胞含量与卒中后3个月时mRS评分呈负相关（r=-0．48，P〈0．05）。结论外周血CD34^＋细胞水平较高的急性脑梗死患者预后较好；CD34^＋细胞水平可作为判断脑梗死患者预后的指标。

Objective To detect the alteration of circulating CD34^＋ cell level in patients with the first-ever nonlactmar stroke and to investigate the prognostic value of CD34^＋ cell level. Methods The level of the circulating CD34^＋ cells were examined using flow cytometry in 119 patients with nonlacunar infarction. The patients were divided into group A （higher than average） and group B （lower than average） according to the detected values. The National Institutes of Health Stroke Scale （NIHSS） scores on admission and the modified Rankin Scale （mRS） scores at 3 months after the onset in the two groups were compared. Results The level of CD34^＋ cells in group A was significantly higher than that in group B （0. 048 ± 0. 001 versus 0. 032 ±0. 002, P 〈 0.05）, however, there was no significantly difference in NIHSS sores between the two groups. One week after admission, the increased level of CD34^＋ cells in group A was significantly higher than that in group B （0. 001± 0. 003 versus -0. 005 ±0. 000, P 〈0.05）.Three months after the onset of symptoms, the average mRS score in group A was significantly superior to that in group B （2. 98 ± 1.14 versus 3.25 ± 1.39, P 〈0.05）. The level of circulating CD34^＋ cells at the initial onset of symptom was negatively correlated with the mRS score at 3 months after stroke （r = -0.48, P 〈0.05）. Conclusions The higher level of circulating CD34^＋ cells had better prognosis in patients with cerebral infarction. The level of circulating CD34^＋ cells may be used as a prognostic indicator in patients with cerebral infarction.