急性脑梗死患者循环内皮祖细胞动态变化及意义

The dynamic changes and significance of circulation endothelial progenitor cells in acute cerebral infarction patients

目的研究急性脑梗死患者内皮祖细胞(endothelial progenitor cell,EPC)水平的动态变化,并探讨其在评价脑卒中预后中的价值。方法收集作者医院收治的急性脑梗死患者148例、健康体检者32名、具有脑血管危险因素者35例,并将脑梗死患者分为进展性脑梗死组和稳定性脑梗死组,采用流式细胞技术检测脑梗死患者不同时期的循环EPC水平。结果 (1)入组时稳定性脑梗死组、进展性脑梗死组、危险因素组EPC水平比较无统计学意义,3组均显著低于健康对照组(P<0.01),稳定性脑梗死组、进展性脑梗死组入组后EPC逐渐上升,第7天达高峰(P<0.05),稳定性脑梗死组EPC水平在第4、7、14天时高于进展性脑梗死组(P<0.05)。(2)脑梗死患者第7天EPC上升值与NIHSS评分改善值呈负相关(r=-0.587,P<0.01)。结论急性期脑梗死1周后EPC明显升高提示预后良好,EPC对预测脑梗死预后具有一定意义。

Objective To investigate the dynamic change of circulation endothelial progenitor cells （EPCs） in acute cerebral infarction, and then evaluate the prognostic value of EPC in acute ischemie stroke. Methods One hundred and forty-eight patients with acute cerebral infarction, 35 patients with risk factors of cerebrovascular disease and 32 healthy controls were included. The cerebral infarction patients were divided into the progressive group and the non-progressive group. The numbers of peripheral blood EPCs were detected by flow cytometry. Results There was no significant difference of the EPCs numbers in the progressive group, the non-progressive group and the risk factor group, but the EPCs numbers in the three groups were significantly lower than that in the control group （P〈0.01）. The levels of EPCs in the progressive group and the nonprogressive group increased gradually after admission, peaked at day 7 （P〈0.05） and declined slightly at day 14 （P〉0.05）. The levels of EPCs in the non-progressive group were raised higher than that in the progressive group at day 4, 7, 14 （P〈0.05）. The EPCs increment had negative correlation with the improvement in NIHSS score at day 7 （r =- 0. 587, P〈 0.01）. Conclusions The increase of circulating EPCs after acute ischemic stroke is associated with good functional outcome. EPCs level has certain significance in predicting cerebral infarction outcome.