CAJ | 학술논문

目的研究AD患者外周血内皮祖细胞(EPCs)数目及脑血流速度、血小板计数等临床资料与认知功能的关系.方法选择自2008年至2009年于天津医科大学总医院老年神经科就诊的患者78例,按照疾病种类分成3组:AD组(23例),血管性痴呆(VaD)组(25例),认知功能正常组(30例).采集患者一般临床资料,TCD检查评价大脑中动脉血流速度,颈动脉彩色TCD检查颈动脉内膜中层厚度(IMT),流式细胞仪检测外周血EPCs数目,简易精神状态量表(MMSE)评分测定认知功能.结果 3组患者间性别、年龄、体重指数、血压、血脂、血小板计数、IMT差异均无统计学意义(P＞0.05).AD、VaD组患者外周血中EPCs数目、MMSE评分、脑血流速度均较认知功能正常组明显减少,差异有统计学意义(P＜0.05).排除常见危险因素的影响后,外周血EPCs数目与MMSE评分呈正相关(r=0.541,P=0.000).多元线性回归分析提示,AD组患者MMSE评分、体重指数,舒张压、血小板计数与外周血EPCs数目有关(P＜0.05).结论 AD患者外周血EPCs数目明显减少,其导致的脑血管修复能力下降、脑灌注不良可能与AD患者的认知功能障碍有关.
목적 연구AD환자외주혈내피조세포(EPCs)수목급뇌혈류속도、혈소판계수등림상자료여인지공능적관계.방법 선택자2008년지2009년우천진의과대학총의원노년신경과취진적환자78례,안조질병충류분성3조:AD조(23례),혈관성치태(VaD)조(25례),인지공능정상조(30례).채집환자일반림상자료,TCD검사평개대뇌중동맥혈류속도,경동맥채색TCD검사경동맥내막중층후도(IMT),류식세포의검측외주혈EPCs수목,간역정신상태량표(MMSE)평분측정인지공능.결과 3조환자간성별、년령、체중지수、혈압、혈지、혈소판계수、IMT차이균무통계학의의(P＞0.05).AD、VaD조환자외주혈중EPCs수목、MMSE평분、뇌혈류속도균교인지공능정상조명현감소,차이유통계학의의(P＜0.05).배제상견위험인소적영향후,외주혈EPCs수목여MMSE평분정정상관(r=0.541,P=0.000).다원선성회귀분석제시,AD조환자MMSE평분、체중지수,서장압、혈소판계수여외주혈EPCs수목유관(P＜0.05).결론 AD환자외주혈EPCs수목명현감소,기도치적뇌혈관수복능력하강、뇌관주불량가능여AD환자적인지공능장애유관.
Objective To study such clinical characteristics as number of circulating endothelial progenitor cells (EPCs), cerebral blood flow velocity (CAFV) and platelet count in patients with Alzheimer' s disease (AD). Methods A total of 78 patients were recruited from the outpatient and inpatient departments of our hospital. Patients with AD (n=23), patients with vascular dementia (VaD,n=25) and healthy elderly controls with normal cognition (n=30) were enrolled after matching for clinical data, carotid intima-media thickness (IMT) and Mini Mental State Examination (MMSE). The CAFV was examined with transcranial Doppler (TCD). Peripheral blood EPCs were counted by flow cytometry.Results No statistical significant differences were noted between patients with AD and VaD, and controls on gender, age, body mass index, blood pressure, total cholesterol, triglycerides, platelet and IMT (P＞0.05). Compared with those in control group, the number of circulating EPCs and scores of MMSE and CAFV in patients with AD and VaD were significantly decreased (P＜0.05). After the adjustment of traditional risk factors, thc number of circulating EPCs had a positive correlation with the scores of MMSE (r=0.541, P=0.000). Liner regression analyses showed that body mass index, diastolic pressure,platelet and scores of MMSE were positively correlated to the circulating EPCs number in patients with AD (P＜0.05). Conclusion The reduction of number of circulating EPCs, decreasing the repair capability of cerebrovasculars and inducing poor cerebral perfusion, plays important roles in the cognitive dysfunction of patients with AD.