CAJ | 학술논문

目的观察急性脑梗死患者外周血CD34+细胞水平的变化,探讨其与脑血管病危险因素、神经功能缺损评分及颈动脉内膜-中层厚度(IMT)的相关性.方法选择急性期脑梗死(发病72 h内)患者45例(梗死组)和具有脑血管危险因素的非脑梗死患者27例(高危组)为研究对象.记录两组患者脑血管病危险因素,包括酗酒史、吸烟史、冠心病、高血压、糖尿病、血清三酰甘油、总胆固醇、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平;通过流式细胞仪测定两组患者外周血CD34+细胞水平,再将两组外周血CD34+细胞水平与脑血管病危险因素进行相关性分析;分别记录梗死组神经功能缺损评分及颈动脉IMT,将外周血CD34+细胞水平与神经功能缺损评分及颈动脉IMT进行相关性分析.结果 (1)脑血管病危险因素中冠心病、高血压、糖尿病和LDL-C水平均与外周血CD34+细胞水平呈显著负相关(r分别为-0.749,-0.717,-0.688,-0.764),差异均有统计学意义(P＜0.01);(2)通过多元线性回归分析得出外周血CD34+细胞水平可以作为急性脑梗死的独立影响因素(P＜0.05);(3)梗死组患者外周血CD34+细胞水平低于高危组,其与神经功能缺损评分呈负相关(r=-0.721,P＜0.01),与颈动脉IMT亦呈负相关(r=-0.695,P＜0.01).结论外周血CD34+细胞水平可以作为急性脑梗死的独立影响因素;急性脑梗死患者外周血CD34+细胞水平与神经功能缺损评分及颈动脉IMT呈显著负相关;外周血CD34+细胞水平可以作为缺血性脑卒中患者早期血管内皮功能的细胞学标志物.
목적 관찰급성뇌경사환자외주혈CD34+세포수평적변화,탐토기여뇌혈관병위험인소、신경공능결손평분급경동맥내막-중층후도(IMT)적상관성.방법 선택급성기뇌경사(발병72 h내)환자45례(경사조)화구유뇌혈관위험인소적비뇌경사환자27례(고위조)위연구대상.기록량조환자뇌혈관병위험인소,포괄후주사、흡연사、관심병、고혈압、당뇨병、혈청삼선감유、총담고순、저밀도지단백담고순(LDL-C)、고밀도지단백담고순(HDL-C)수평;통과류식세포의측정량조환자외주혈CD34+세포수평,재장량조외주혈CD34+세포수평여뇌혈관병위험인소진행상관성분석;분별기록경사조신경공능결손평분급경동맥IMT,장외주혈CD34+세포수평여신경공능결손평분급경동맥IMT진행상관성분석.결과 (1)뇌혈관병위험인소중관심병、고혈압、당뇨병화LDL-C수평균여외주혈CD34+세포수평정현저부상관(r분별위-0.749,-0.717,-0.688,-0.764),차이균유통계학의의(P＜0.01);(2)통과다원선성회귀분석득출외주혈CD34+세포수평가이작위급성뇌경사적독립영향인소(P＜0.05);(3)경사조환자외주혈CD34+세포수평저우고위조,기여신경공능결손평분정부상관(r=-0.721,P＜0.01),여경동맥IMT역정부상관(r=-0.695,P＜0.01).결론 외주혈CD34+세포수평가이작위급성뇌경사적독립영향인소;급성뇌경사환자외주혈CD34+세포수평여신경공능결손평분급경동맥IMT정현저부상관;외주혈CD34+세포수평가이작위결혈성뇌졸중환자조기혈관내피공능적세포학표지물.
Objective To observe the change of peripheral blood CD34+ cell level in patients with acute cerebral infarction, and explore its relationships with cerebrovascular risk factors,neurological function and carotid artery intima-media thickness (IMT). Methods The 45 patients with acute cerebral infarction (onset within 72 h) (infarction group) and 27 patients with cerebr ovascular risk factors but without cerebral infarction (high-risk group) were chosen for the study. The cerebrovascular disease risk factors including history of alcohol abuse, smoking, coronary heart disease, hypertension, diabetes, abnormal levels of serum triglycerides, total cholesterol,low-density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol (HDL-C) were recorded in all subjects. The peripheral blood CD34+ cell levels were measured by flow cytometry.The correlations of peripheral blood CD34+ cell level with cerebrovascular disease risk factors were analyzed. The neurological function and carotid artery IMT were recorded in infarction group, and the correlations of peripheral blood CD34+ cell level with neurological function and carotid artery IMT were analyzed. Results (1) The peripheral blood CD34+ cell level was significantly negatively correlated with coronary heart disease, hypertension, diabetes and LDL-C level (r =- 0. 749,-0. 717, - 0. 688, - 0. 764, all P＜0. 01) ; (2) Multiple linear regression analysis showed that peripheral blood CD34+ cell level was an independent relative factor of acute cerebral infarction (P＜0.05); (3) The peripheral blood CD34+ cell level was lower in infarction group than in high-risk group, and was significantly negatively correlated with neurological deficit score (r=-0. 721, P＜0.01) and carotid artery IMT (r= -0. 695, P＜0. 01). Conclusions Peripheral blood CD34+ cell level could be an independent relative factor of acute cerebral infarction; The peripheral blood CD34+ cell level is significantly negatively correlated with neurological function and carotid artery IMT in patients with acute cerebral infarction; And it can be used as cytological marker which reflect early vascular endothelial function in patients with ischemic stroke.