上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2017, Vol. 37 ›› Issue (7): 964-.doi: 10.3969/j.issn.1674-8115.2017.07.014

• 论著（临床研究） • 上一篇    下一篇

循环内皮祖细胞对急性缺血性脑卒中预后的预测价值

岳丹丹 1,2，魏珍玉 1，陈昕 1，王岬琰 1，卢文美 1，钟萍 3，吴丹红 1   

  1. 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
  • 出版日期:2017-07-28 发布日期:2017-08-25
  • 通讯作者: 吴丹红，电子信箱：wudanhong@5thhospital.com
  • 作者简介:岳丹丹（1988—），女，住院医师，硕士；电子信箱：ydjiaoda2013@163.com
  • 基金资助:
     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）

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

YUE Dan-dan1,2, WEI Zhen-yu1, CHEN Xin1, WANG Jia-yan1, LU Wen-mei1, ZHONG Ping3, WU Dan-hong1   

  1. 1. Department of Neurology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201999, China; 2. Department of Cardiology, Shidong Hospital, Shanghai 200438, China; 3. Department of Encephalopathy, Shanghai TCM-integrated Hospital, Shanghai University of TCM, Shanghai 200082, China
  • Online:2017-07-28 Published:2017-08-25
  • Supported by:
     Scientific Research Project of Science and Technology Committee of Shanghai Municipality, 14411972000; Scientific Research Project of Shanghai Municipal Commission of Health and Family Planning , 201440332; Innovation Fund for Translational Medicine in Shanghai Jiao Tong University School of Medicine,152H2013

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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。

关键词: &ensp, 急性缺血性脑卒中, 循环内皮祖细胞, 改良 Rankin 评分, 预后

Abstract:

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.

Key words:  acute ischemic stroke, circulating endothelial progenitor cell, modified Rankin Scale, prognosis