循环内皮祖细胞对急性缺血性脑卒中预后的预测价值  

Predictive value of circulating endothelial progenitor cells in prognosis of acute ischemic stroke

作　　者：岳丹丹[1,2] 魏珍玉[1] 陈昕[1] 王岬琰 卢文美 钟萍[3] 吴丹红[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院神经内科,上海201999 [2]上海市杨浦区市东医院心内科,上海200438 [3]上海中医药大学附属上海市中西医结合医院脑病科,上海200082

出　　处：《上海交通大学学报（医学版）》2017年第7期964-968,共5页Journal of Shanghai Jiao tong University:Medical Science

基　　金：上海市科学技术委员会科研计划项目(14411972000);上海市卫生与计划生育委员会科研课题计划(201440332);上海交通大学医学院转化医学创新基金(152H2013)~~

摘　　要：目的·研究急性缺血性脑卒中(AIS)患者循环内皮祖细胞(cEPCs)发病1周内的变化,并研究cEPCs与AIS预后的关系。方法·选择AIS患者92例(AIS组)及危险因素控制组(Risk组)20例。AIS患者分别于入院第1日和发病第7日采血,用流式细胞术检测cEPCs(CD34+KDR+细胞)在外周血单个核细胞中的比例;在发病后90 d应用改良Rankin评分(mRS)评估患者脑卒中后功能恢复结局,比较不同预后结局患者的cEPCs比例,分析cEPCs比例与预后的关系。结果·与Risk组相比,AIS组入院第1日cEPCs比例降低,差异有统计学意义(P=0.016)。在AIS组内,与预后不良组(mRS>2分)比较,预后良好组(mRS≤2分)患者发病第7日cEPCs比例显著升高(P=0.002);多元线性回归分析结果显示,发病第7日cEPCs的比例与发病后90 d的mRS评分呈正相关(t=4.608,P=0.011)。结论·AIS患者急性期外周血中cEPCs比例显著降低,发病第7日cEPCs的比例与患者预后具有相关性。Objective · To study the change of circulating endothelial progenitor cells （cEPCs） in acute ischemic stroke （AIS） patients within one week after attack, and the correlation of cEPCs with the prognosis. Methods · Ninty-two patients with AIS （AIS group） and 20 patients with risk factors （Risk group） were recruited. The proportion of cEPCs （CD34＋KDR＋ cells） in peripheral blood mononuclear cells of AIS patients was measured by flow cytometry （FCM） on the first day of admission and the seventh day after attack. Functional recovery was assessed by modified Rankin Scale （mRS） on the 90th day after onset. The cEPCs percentages of AIS patients with different mRS were compared to analyze their correlation. Results · Compared with Risk group, cEPCs percentage of AIS group on the 1st day of admission was lower （P=0.016）. In AIS group, compared with poor prognosis group （mRS〉2）, cEPCs percentage of good prognosis group on the 7th day after onset （mRS ≤ 2） elevates （P=0.002）. The result of multiple linear regression showed that cEPCs percentage on the 7th day after onset was positively correlated with mRS on the 90th day （t=4.608, P=0.011）. Conclusion · The percentage of cEPCs in peripheral blood of AIS patients decreases significantly during the acute phase. The percentage on the 7th day after onset is correlated with prognosis of AIS patients.

关 键 词：急性缺血性脑卒中 循环内皮祖细胞 改良Rankin评分 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]