重型颅脑损伤后外周血内皮祖细胞的变化及与预后的关系

Correlation of percentage of endothelial progenitor cells in peripheral blood with prognosis in severe craniocerebral injury

目的探讨重型颅脑外伤后，外周血中内皮祖细胞（endothelial progenitor cells，EPCs）的变化及与预后的关系。方法选择2013年8月至2014年1月重庆市巴南区人民医院神经外科收治的10例重型颅脑损伤并行常规保守治疗且受伤时无肢体损伤（目的是为排除其他损伤导致的外周血EPCs变化）的患者作为病例组，其中男性为7例，女性为3例，年龄19～62（40．8±15．0）岁。选择同期10例健康者作为对照，年龄29～66（38．4±11．4）岁。分别在患者入院后1、4、7、14d收集其外周血，通过流式细胞术检测其EPCs的百分率，分析EPCs的变化规律及与GCS评分改善的关系。结果与对照组相比，重型颅脑损伤循环EPCs含量从第1～4天逐渐降低，从第4～7天逐渐升高，第14天逐渐恢复至正常水平（P〈0．05，P〈0．01）。重型颅脑外伤患者外周血的EPCs含量分别在第7天（r=0．57，P〈0．05）和第14天与GCS评分差呈正相关性（r=0．68，P〈0．05）。结论重型颅脑损伤后循环血中EPCs的含量与预后有关。

Objective To investigate the change blood of patients with severe craniocerebral injury and its of endothelial progenitor cells （EPCs） in peripheral prognostic significance. Methods A total of 10 patients with severe craniocerebral injury admitted in Banan District People＇ s Hospital were enrolled in this study. Their peripheral blood samples were harvested at the 1 st, 4th, 7th and 14th days after admission. The percentage of EPCs was detected by flow cytometry. The relationship of change rule of EPCs percentage with Glasgow coma scale （GCS） score was analyzed. Results Compared with blank group, the percentage of EPCs in peripheral blood was reduced at the 1st and 4th days, and gradually increased at the 7th day, and then returned to normal level at the 14th day （P 〈 0.05, P 〈 0.01 ）. There were positive correlation of the percentage of EPCs at the 7th day （ r = 0.57,P 〈 0.05 ） and 14th day （ r = 0.68, P 〈 0.05 ） with GCS score. Conclusion There is positive correlation between the percentage of EPCs and prognosis of severe craniocerebral injury.