循环内皮祖细胞在老年人缺血性脑血管病不良事件中的影响  

Effect of circulating endothelial progenitor cells on adverse cerebrovascular events in the elderly with ischemic cerebrovascular disease

作　　者：张释双[1] 孔晓冬[1] 夏颖华[1] 卫重娟[1] 陈心[2] 尉辉杰[2] 金薇娜[2] 雷平[1] 

机构地区：[1]天津医科大学总医院保健医疗部老年病科天津市老年病学研究所,300052 [2]天津医科大学总医院神经科天津市神经病学研究所教育部“中枢神经系统创伤修复与再生”重点实验室天津市“神经损伤变异与再生”重点实验室,300052

出　　处：《中华老年医学杂志》2016年第7期697-701,共5页Chinese Journal of Geriatrics

基　　金：国家自然科学基金（81370029）;国家自然科学基金青年项目（81200907、81301044）;天津市卫生局科技基金（2015KZ118）;天津医科大学总医院青年孵育基金（ZYYFY2015034）;天津市应用基础与前沿技术研究计划青年项目（12JCQNJC6800）

摘　　要：目的探讨循环内皮祖细胞（EPCs）在预测老年人缺血性脑血管病预后及死亡率中的价值。方法选择2010年至2012年在天津医科大学总医院保健医疗部门诊统一查体且有缺血性脑血管病史100例作为研究对象，收集患者年龄、性别、血压、血糖、血脂、既往史、治疗药物等一般资料，对其外周血进行流式细胞分析，以CD34^＋／CD133^＋的阳性细胞作为EPCs标记，检测EPCs数量。根据EPCs数目水平分成低、高两组，随访18个月，观察研究对象心脑血管疾病等相关事件的发生。结果两组人群间年龄、性别、血压、血脂、疾病史、危险因素、治疗史等比较差异均无统计学意义（P〉0．05）；低水平EPCs组较高水平EPCs组第1次住院事件及脑血管病事件明显增多（P〈0．05）；而两组之间发生的心血管病事件、心肌梗死事件、脑血管病引起的死亡事件、心血管病引起的死亡事件、其他原因引起的死亡事件差异均无统计学意义（均P〉0．05）。结论循环内皮祖细胞水平可作为老年缺血性脑血管病事件的预测指标，可帮助患者对缺血性脑血管病的发生进行早期预防及早期干预。Objective To investigate the value of endothelial progenitor cells （EPCs） in predicting the prognosis of ischemic cerebrovascular disease and mortality in the elderly. Methods A total of 100 elderly patients with ischemic cerebrovascular disease were recruited from the outpatient medical checkup division of our hospital. Clinical data including age, gender, blood pressure, blood glucose, blood lipids, medical history and medications were collected. Circulating EPCs were identified as cell surface markers CD34/CD133 double-positive cells using flow cytometry analysis. Patients were divided into the low and high groups based on the counts of circulating EPCs. After 18 months of follow-up, we evaluated the occurrence of cerebrovascular events. Results There were no significant statistical differences in age, gender, blood pressure, blood lipids, disease history, risk factors or treatment history between the two groups （all P 〉 0.05）. The incidences of first hospitalization and cerebrovascular events were higher in the high group than in the low group （both P d0.05）. No statistically significant differences were noted between the two groups in cardiovascular events, myocardial infarction events, deaths caused by cerebrovascular disease, cardiovascular disease or other causes of deaths （all P〉0.05）. Conclusions Circulating endothelial progenitor cell levels can be considered as a predictor for ischemic eerebrovascular events in the elderly and may be helpful in early prevention and intervention of ischemic cerebrovascular disease in elderly patients.

关 键 词：内皮细胞 干细胞 脑血管障碍 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]