循环内皮祖细胞异位表达骨钙素在缺血性脑血管病发病中的作用

Abnormal Expression of Osteocalcin on Circulating Endothelial Progenitor Cells in Patients with Ischemic Cerebrovascular Diseases

目的检测缺血性脑血管病惠者循环内皮祖细胞(endothelial progenitor cells,EPCs)表达骨钙素(osteocalcin,OCN)的绝对数量和相对比例,为评价血管病变提供参考指标。方法采用病例对照研究方法,比较病例组(n=51)和对照组(n=30)缺血性脑血管病传统危险因素的差异;应用流式细胞仪检测外周血EPCs数量及OCN表达水平,建立logistic回归方程。结果病例组EPCs数目、OCN阳性的EPCs数目以及其百分比均显著高于对照组(均P<0.01)。病例组中,钙化组OCN阳性的EPCs百分比高于非钙化组(P=0.033),而不同程度的脑血管狭窄组之间,OCN阳性的EPCs百分比差异无统计学意义(P=0.672)。OCN阳性的EPCs百分比是缺血性脑血管病发病的独立危险因素(优势比为1.143,95%可信区间为1.060～1.232)。结论缺血性脑血管病患者循环EPCs表达OCN,对血管损伤具有负性影响,而非单一的修复作用。OCN阳性的EPCs可作为评价缺血性脑血管病变的细胞学指标。

Objective To explore whether endothelial progenitor cells（EPCs） in patients with cerebrovascular diseases could express high level of osteocalcin. Methods We studied 51 patients with acute cerebrovascular diseases and 30 sex- and age- matched control subjects. EPCs in peripheral blood mononuclear cells were analyzed by flow cytometry. Results Patients with cerebral ischemia had about three-fold increase of the number and the percentage of osteocalcin positive（OCN＋） EPCs compared with control group（P〈0.01）. Patients with vessel calcification had higher percentage of OCN＋EPCs than those without calcification（P=0.033）. However, the degree of stenosis had no direct correlation with osteocalcin expression（P=0.672）. Logistic analysis showed that the percentage of OCN＋EPCs was an independent risk factor for cerebral ischemia（odds ratio： 1.143, 95% confidence intervals 1.060-1.232）. Conclusion Circulating endothelial progenitor cells in patients suffering from cerebral ischemia can express osteocalcin and act as a negative factor for vascular lesion rather than normal repair. The percentage of OCNEPCs may be used as a potential cell marker for ischemic cerebrovascular diseases.