中国老年学杂志
中國老年學雜誌
중국노년학잡지
CHINESE JOURNAL OF GERONTOLOGY
2015年
16期
4520-4524
,共5页
项正兵%屈新辉%王万松%张昆南%吴晓牧
項正兵%屈新輝%王萬鬆%張昆南%吳曉牧
항정병%굴신휘%왕만송%장곤남%오효목
急性脑梗死%内皮祖细胞
急性腦梗死%內皮祖細胞
급성뇌경사%내피조세포
Acute cerebral infarction%Endothelial progenitor cells
目的：探讨脑血管病危险因素对内皮祖细胞（ EPCs）的影响以及急性脑梗死患者 EPCs和神经功能缺损评分（ NIHSS）的动态变化。方法选择60例急性脑梗死、60例脑梗死后遗症、60例具有脑血管病危险因素的患者和30例健康体检者，以 CD133和 KDR双阳性细胞作为 EPCs标记，用流式细胞仪检测外周血EPCs数量，以NIHSS评分评价神经功能缺损程度。分析外周血EPCs数量与脑血管各危险因素的关系以及急性脑梗死患者EPCs数量动态变化与NIHSS评分改善的相关性。结果急性脑梗死组、脑梗死后遗症组、危险因素组患者外周血EPCs数量均低于健康对照组（均P＜0．01）。急性脑梗死患者在发病72 h～21 d时，外周血EPCs数量均较发病24 h时间点高（均P＜0．05），发病后EPCs逐渐升高，且在14 d时间点达高峰（P＜0．01），此后逐渐下降，在30～90 d时EPCs水平与发病24 h无差异（P＞0．05）。吸烟史、高血压病史、糖尿病史、高脂血症病史是脑血管病外周血EPCs独立的影响因素。外周血EPCs数量与舒张压、糖化血红蛋白、总胆固醇、低密度脂蛋白呈负相关（均P＜0．05），与收缩压、空腹血糖、甘油三酯无关（均P＞0．05）。急性脑梗死患者在24 h～14 d时，NIHSS评分随着外周血EPCs上升而改善；脑梗死患者急性期 NIHSS评分与外周EPCs呈负相关（均P＜0．01）；在发病后21～90 d时，这种相关性不复存在。结论急性脑梗死患者外周血EPCs数量呈动态变化，且数量上升时患者的神经功能改善。检测外周静脉血EPCs数量可以判断急性脑梗死患者预后。
目的：探討腦血管病危險因素對內皮祖細胞（ EPCs）的影響以及急性腦梗死患者 EPCs和神經功能缺損評分（ NIHSS）的動態變化。方法選擇60例急性腦梗死、60例腦梗死後遺癥、60例具有腦血管病危險因素的患者和30例健康體檢者，以 CD133和 KDR雙暘性細胞作為 EPCs標記，用流式細胞儀檢測外週血EPCs數量，以NIHSS評分評價神經功能缺損程度。分析外週血EPCs數量與腦血管各危險因素的關繫以及急性腦梗死患者EPCs數量動態變化與NIHSS評分改善的相關性。結果急性腦梗死組、腦梗死後遺癥組、危險因素組患者外週血EPCs數量均低于健康對照組（均P＜0．01）。急性腦梗死患者在髮病72 h～21 d時，外週血EPCs數量均較髮病24 h時間點高（均P＜0．05），髮病後EPCs逐漸升高，且在14 d時間點達高峰（P＜0．01），此後逐漸下降，在30～90 d時EPCs水平與髮病24 h無差異（P＞0．05）。吸煙史、高血壓病史、糖尿病史、高脂血癥病史是腦血管病外週血EPCs獨立的影響因素。外週血EPCs數量與舒張壓、糖化血紅蛋白、總膽固醇、低密度脂蛋白呈負相關（均P＜0．05），與收縮壓、空腹血糖、甘油三酯無關（均P＞0．05）。急性腦梗死患者在24 h～14 d時，NIHSS評分隨著外週血EPCs上升而改善；腦梗死患者急性期 NIHSS評分與外週EPCs呈負相關（均P＜0．01）；在髮病後21～90 d時，這種相關性不複存在。結論急性腦梗死患者外週血EPCs數量呈動態變化，且數量上升時患者的神經功能改善。檢測外週靜脈血EPCs數量可以判斷急性腦梗死患者預後。
목적：탐토뇌혈관병위험인소대내피조세포（ EPCs）적영향이급급성뇌경사환자 EPCs화신경공능결손평분（ NIHSS）적동태변화。방법선택60례급성뇌경사、60례뇌경사후유증、60례구유뇌혈관병위험인소적환자화30례건강체검자，이 CD133화 KDR쌍양성세포작위 EPCs표기，용류식세포의검측외주혈EPCs수량，이NIHSS평분평개신경공능결손정도。분석외주혈EPCs수량여뇌혈관각위험인소적관계이급급성뇌경사환자EPCs수량동태변화여NIHSS평분개선적상관성。결과급성뇌경사조、뇌경사후유증조、위험인소조환자외주혈EPCs수량균저우건강대조조（균P＜0．01）。급성뇌경사환자재발병72 h～21 d시，외주혈EPCs수량균교발병24 h시간점고（균P＜0．05），발병후EPCs축점승고，차재14 d시간점체고봉（P＜0．01），차후축점하강，재30～90 d시EPCs수평여발병24 h무차이（P＞0．05）。흡연사、고혈압병사、당뇨병사、고지혈증병사시뇌혈관병외주혈EPCs독립적영향인소。외주혈EPCs수량여서장압、당화혈홍단백、총담고순、저밀도지단백정부상관（균P＜0．05），여수축압、공복혈당、감유삼지무관（균P＞0．05）。급성뇌경사환자재24 h～14 d시，NIHSS평분수착외주혈EPCs상승이개선；뇌경사환자급성기 NIHSS평분여외주EPCs정부상관（균P＜0．01）；재발병후21～90 d시，저충상관성불복존재。결론급성뇌경사환자외주혈EPCs수량정동태변화，차수량상승시환자적신경공능개선。검측외주정맥혈EPCs수량가이판단급성뇌경사환자예후。
Objective To observe the risk factors of cerebrovascular disease on peripheral endothelial progenitor cells (EPCs) in a-cute cerebral ischemic ( ACI) patients and investigate the correlation with the variations of EPCs and neurological function .Methods Three groups of patients including ACI group (60 cases),cerebral infarction sequel group (60 cases),the risk factors group (60 cases) as well as healthy control group (30 cases)were selected.CD133+/KDR+cells were considered as EPCs.Peripheral blood EPCs was quantified by flow cytometry assay.The NIH stroke scale(NIHSS) was used to assess the neurological function of patients with ACI group at 24,72 h,7,14,21, 30,60 and 90 d after the onset of cerebral infarction .The correlation of cerebrovascular disease risk factors consist of age ,gender,past histo-ry,smoking history,systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting plasma glucose(FPG),glycosylated hemoglobin (HbA1c),triglycerides(TG),total cholesterol(TC),high density lipoprotein(HDL) and low density lipoprotein(LDL) with peripheral EPCs as well as the correlation with the variations of EPCs in the ACI group and neurological function at different time points after onset were ana -lyzed.Results Compared with those of healthy control group ,the number of EPCs in ACI group ,cerebral infarction sequel group and the risk factors group were decreased (P<0.01).Compared with 24 h after the onset of cerebral infarction ,the number of EPCs during 72 h to 21 d af-ter the onset was increased (P<0.05).EPCs was gradually increased until reaching the peak from the onset to 14 d after ACI(P<0.01), then gradually decreased until reaching the same level during 30~90 d compared with 24 h after onset (P>0.05).Smoking,hypertension,di-abetes and hyperlipidemia were independent influence factors of cerebrovascular disease .The number of peripheral EPCs in ACI group ,cere-bral infarction sequel group and the risk factors group had negative correlation with DBP ,HbA1c,TC and LDL(P<0.05),and no correlation with SBP,FPG and TG(P>0.05).The NIHSS score of patients with ACI had negative correlation with peripheral EPCs during 24 h to 14 d after onset ( P<0.05) and no correlation after onset of 21 d to 90 d.Conclusions Peripheral EPCs in patients with ACI have a dynamic var-iations at different time points after onset .With the increase of the number of EPCs ,the neurological function is improved .The quantity of pe-ripheral blood EPCs could predict the prognosis of ACI .
