颅内外血管搭桥治疗烟雾病及外周血内皮祖细胞超顺磁性氧化铁颗粒标记的实验研究

Study on endothelial progenitor cells labeling with new superpara-magnetic iron oxide in moyamoya disease treated with superficial temporal artery-to-middle cerebral artery anastomosis

目的研究颅内外血管搭桥治疗的烟雾病患者的临床疗效,以及外周血内皮祖细胞超顺磁性氧化铁颗粒标记的实验。方法选取我院于2015年1月-2016年1月间我院收治的76例烟雾病患者作为研究对象,将所有患者随机分为两组,分别为试验组和对照组,每组38例。试验组采用颅内外血管搭桥术,对照组采用抗血栓药物治疗。观察两组患者临床疗效,检测患者治疗前后脑血供情况、再发脑出血和再发脑缺血发生率、内皮祖细胞含量水平。分离烟雾病患者内皮祖细胞、培养、鉴定,采用超顺磁性氧化铁颗粒标记,采用MTT法内皮祖细胞增殖能力。采用划痕实验方法检测内皮祖细胞迁移能力。结果试验组的总有效率86.84%(33/38)高于对照组的总有效率76.32%(29/38),组间比较差异有统计学意义(P<0.05)。脑血管造影术、脑核磁灌注成像、脑CT灌注成像结果表明,颅内外血管搭桥术治疗后,大脑手术后缺血区的血液供应明显改善,大脑手术后缺血区的脑血流量增加。治疗后,试验组患者再发脑出血比对照组降低(10.53%<23.68%),差异有统计学意义(P<0.05);治疗后,试验组患者再发脑缺血比对照组降低(13.16%<31.58%),差异有统计学意义(P<0.05)。治疗后,试验组患者内皮祖细胞含量较对照组降低,差异有统计学意义(P<0.05)。当超顺磁性氧化铁颗粒浓度范围在0~50μg/m L范围内时,超顺磁性氧化铁颗粒标记度对内皮祖细胞体外增殖活性、迁移能力无明显影响(P>0.05)。结论颅内外血管搭桥术治疗烟雾病患者,临床疗效显著,可降低内皮祖细胞含量水平。0~50μg/m L浓度范围内的超顺磁性氧化铁颗粒标记内皮祖细胞不会影响其增殖活性和迁移能力。

Objective To study on endothelial progenitor cells labeling with new superpara-magnetic iron oxide in moyamo- ya disease treated with superficial temporal artery-to-middle cerebral artery anastomosis. Methods 76 cases patients with moyamo- ya disease in our hospital from 2015 January to 2016 January were analyzed, and divided into treatment group （38 cases） and con- trol group （38 cases ）. Control group was treated with antithrombotie drugs. Treatment group was treated with superficial temporal ar- tery-to-middle cerebral artery anastomosis. After treatment, clinical efficacy, cerebral blood flow, the rate of rebleeding, the rate of cerebral Isehemia and the level of endothelial progenitor cells were evaluated in two groups. Endothelial progenitor cells fi＇om pa- tients with moyamoya disease was isolated, cultured and identified. Endothelial progenitor cells were labeled with new superpara- magnetic iron oxide. MTT test detected cell viability. Scratch test detected cell migration. Results The effective rate in treatment group was obviously higher than control group （86.84%〉76.32%） （P〈0.05）. MR peffusion imaging, CT perfusion imaging, cere- bral angiography show that cerebral blood flow was obviously improved than postoperative （P〈0.05）. The rate of rebleeding in experi- ment group was obviously lower than in control group （10.53%〈23.68%） （P〈0.05）. The rate of cerebral Isehemia in experiment group was obviously lower than in control group （13.16%〈31.58%） （P〈0.05）. The levels of endothelial progenitor cells in experi- ment group was obviously lower than in control group （P〈0.05）. 0-50 μg/mL new superpara-magnetic iron oxide was no toxicity in endothelial progenitor cells （P〈0.05）. Conclusion Superficial temporal artery-to-middle cerebral artery treated with anastomosismoyamoya disease can effectively improve the clinical symptoms, reduce level of endothelial progenitor cells. 0-50 μg/mL new su- perpara-magnetic iron oxide was no toxicity in endothelial progenitor cells.