急性脑梗死患者外周血内皮祖细胞的水平变化及其动员机制分析

Changes of peripheral blood endothelial progenitor cells level and their mobilization mechanismin patients with acute cerebral infarction

目的探讨急性脑梗死后外周血内皮祖细胞（EPCs）的水平变化及其动员机制，为缺血性脑卒中的防治提供新思路。方法选择安徽医科大学附属宿州医院神经内科自2015年1月1日至12月31日收治的首次发病并于24h内入院的急性脑梗死患者50例为脑梗死组，选择同期体检健康者40例为对照组。以CD133＋激酶功能区受体fKDR-）＋细胞作为EPCs的标记，采用流式细胞术检测脑梗死组发病后第1、5、10天及对照组外周血EPCs水平并计算EPCs变化率[（EPCs-EPCsld）／EPCs，d]，同时采用酶联免疫吸附法（ELISA）检测外周血血管内皮生长因子（VEGF）、基质细胞衍生因子．I（SDF．1）含量。结果脑梗死组外周血EPCs水平及VEGF、SDF．1含量均于发病后第5天升高，第10天下降。脑梗死组发病后第1、5、10天外周血EPCs水平均较对照组明显降低，发病后第5、10天外周血VEGF、SDF．1含量均较对照组明显升高，差异均有统计学意义（P〈0．05）。脑梗死组外周血EPCs变化率与发病后第5天VEGF、SDF．1含量呈正相关关系（r=0．639，P=0．000；r==0．553，／9=-0．000），且VEGF含量与SDF-1含量亦呈正相关关系（F0．765，P=0．000）。结论EPCs是急性脑梗死进展的一项重要影响因素。急性脑梗死后外周血EPCs的动员机制与VEGF、SDF-1含量升高有关。

Objective To explore the changes of peripheral blood endothelial progenitor cells （EPCs） level and their mobilization mechanism in patients with acute cerebral infarction （ACI） to provide new ideas for the control of ischemic stroke. Methods Fifty patients with first onset of ACI within 24 h of onset, admitted to our hospital from January 1 to December 31, 2015, were enrolled; 40 healthy subjects were chosen as Control group. The number of EPCs （surface markers： CD133 kinase domain receptor＋） was detected using flow cytometry in the ACI group on one, 5, and 10 d of ACI and the control group. And the EPCs changed rate was defined as （EPCs5 d-EPCs1 d） and EPCS14d ratio. Meanwhile, vascular endothelial growth factor （VEGF） and stromal cell-derived factor-1 （SDF-1） contents were examined by enzyme linked immunosorbent assay. Results The number of EPCs, and VEGF and SDF-1 contents increased gradually on day 5 and decreased on day 10 of ACI. The EPCs number in the ACI group was significantly smaller on day one, 5, and 10 of ACI than control group （P〈0.05）; VEGF and SDF-1 contents of peripheral blood on day 5 and 10 of ACI were significantly increased as compared with those of the control group （P〈0.05）. EPCs changed rate was positively correlated with VEGF and SDF-1 contents on day 5 in ACI group （r= 0.639, P=-0.000; r=0.553, P=-0.000）. And VEGF content was positively correlated with SDF-1 content （r=0.765, P=0.000）. Conclusions EPCs level may be an importantfactor for ACI. The mechanism of EPCs mobilization may be associated with increased expressions of VEGF and SDF-1 after ACI.