CAJ | 학술논문

目的测定急性脑梗死患者外周血CD34 +细胞水平,并探讨其临床意义. 方法采用流式细胞仪测定发病72 h以内的急性期脑梗死患者(梗死组,45例)、有脑血管危险因素但无脑梗死发生的患者(高危组,27例)和健康体检者(对照组,20例)外周血CD34+细胞水平,分别记录梗死组患者神经功能缺损评分、梗死病灶体积以及颈动脉内中膜厚度. 结果梗死组(0.034±0.012)％与高危组(0.047±0.009)％患者外周血CD34+细胞百分比均低于对照组(0.063±0.009)％,且梗死组低于高危组(均P＜0.05)；梗死组轻度(0.047±0.009)％、中度(0.036±0.009)％、重度(0.022±0.007)％神经功能缺损评分患者外周血CD34+细胞百分比均较对照组降低(P＜0.05),重度组低于中度组,中度组低于轻度组(均P＜0.05)；梗死组外周血CD34+细胞百分比均明显低于对照组(P＜0.05),其中大灶组低于中灶组,中灶组低于小灶组(均P＜0.05)；(4)颈动脉内膜增厚组(0.043±0.010)％、颈动脉斑块组(0.036±0.010)％及颈动脉狭窄组(0.023±0.009)％,3组患者外周血CD34+细胞百分比均较对照组显著降低.其中颈动脉斑块及颈动脉狭窄组低于颈动脉斑块组,颈动脉斑块组低于颈动脉内膜增厚组(均P＜0.05). 结论外周血CD34+细胞水平在脑缺血急性期明显降低,与脑梗死后神经功能缺损程度、梗死灶体积、颈动脉粥样硬化程度有关.
목적 측정급성뇌경사환자외주혈CD34 +세포수평,병탐토기림상의의. 방법 채용류식세포의측정발병72 h이내적급성기뇌경사환자(경사조,45례)、유뇌혈관위험인소단무뇌경사발생적환자(고위조,27례)화건강체검자(대조조,20례)외주혈CD34+세포수평,분별기록경사조환자신경공능결손평분、경사병조체적이급경동맥내중막후도. 결과 경사조(0.034±0.012)％여고위조(0.047±0.009)％환자외주혈CD34+세포백분비균저우대조조(0.063±0.009)％,차경사조저우고위조(균P＜0.05)；경사조경도(0.047±0.009)％、중도(0.036±0.009)％、중도(0.022±0.007)％신경공능결손평분환자외주혈CD34+세포백분비균교대조조강저(P＜0.05),중도조저우중도조,중도조저우경도조(균P＜0.05)；경사조외주혈CD34+세포백분비균명현저우대조조(P＜0.05),기중대조조저우중조조,중조조저우소조조(균P＜0.05)；(4)경동맥내막증후조(0.043±0.010)％、경동맥반괴조(0.036±0.010)％급경동맥협착조(0.023±0.009)％,3조환자외주혈CD34+세포백분비균교대조조현저강저.기중경동맥반괴급경동맥협착조저우경동맥반괴조,경동맥반괴조저우경동맥내막증후조(균P＜0.05). 결론 외주혈CD34+세포수평재뇌결혈급성기명현강저,여뇌경사후신경공능결손정도、경사조체적、경동맥죽양경화정도유관.
Objective To determine the level of peripheral blood CD34 positive (CD34+) cells in patients with acute cerebral infarction (ACI),and to explore its clinical significance.Methods The level of peripheral blood CD34+ cells was determined by flow cytometry within 72 hours of onset of patients with acute cerebral infarction (infarct group,n=45),cerebrovascular risk factors in patients without cerebral infarction (high risk group,n=27) and healthy subjects (control group,n=20).The neural function defect score,infarction lesion volume and carotid artery intima-media thickness (IMT) were determined in patients with infarction group.Results The percentages of peripheral blood CD34 cells in infarction group (0.034 ±0.012)％ and the high risk group of patients (0.047±0.009)％ were lower than that of control group(0.063±0.009)％,and were lower in infarction group than in high-risk groups (all P＜0.05).The percentages of peripheral blood CD34+cells were significantly decreased compared with control group (P＜0.05) in infarction patients with mild [(0.047±0.009)％],moderate [(0.036±0.009)％],severe [(0.022±0.007)％] infarction nervous function defect score.Wherein,the percentages were lower in severe group than in the moderate group,moderate group was lower than in mild group (all P＜0.05).The percentages of peripheral blood CD34 cells in infarction patients with small,moderate,large infaret lesion volume were lower than in control group (P＜0.05),wherein,were lower in large group than in moderate group,lower in moderate group than in treatment group (all P＜0.05).Infarction patients were confirmed with carotid atherosclerosis (CAS) by carotid ultrasound.The extent of lesion were divided into carotid artery intimal thickening group [(0.043±0.010)％],carotid artery plaque group [(0.036±0.010)％],and carotid artery stenosis group [(0.023±0.009)％].The levels of peripheral blood CD34+ cells in three groups of patients were decreased compared with control group.The levels were lower in carotid artery stenosis group than in carotid artery plaque group,lower in carotid artery plaque group than in carotid artery intimal thickening group (all P＜0.05).Conclusions The level of peripheral blood CD34+ cells in acute cerebral ischemia is reduced,it can become a sensitive and early indicator of cerebral ischemia,and its level is related to neurologic impairment,infarction size and the degree of carotid artery atherosclerosis.