短暂脑缺血发作后继脑梗死患者循环内皮祖细胞的变化及意义

目的探讨短暂脑缺血发作(TIA)后继脑梗死患者早期外周血循环内皮祖细胞(EPCs)的变化及意义。方法序贯收集首次脑梗死患者58例,根据病前有无同侧TIA史分为TIA组(26例)和非TIA组(32例),另选取16例健康志愿者为正常对照。以NIHSS评分评价神经功能缺损程度;根据头部CT测定脑梗死灶体积;以CD34和KDR双阳性细胞作为EPCs标记,用流式细胞仪测定早期外周血循环EPCs数量,以ELISA检测血管内皮生长因子(VEGF)含量。分析循环EPCs数量与神经功能缺损程度、脑梗死体积及血清VEGF含量间的相关性。结果 TIA组患者NIHSS评分及梗死体积明显小于非TIA组(均P0.01)。非TIA组患者外周血循环EPCs数量与正常对照组有上升趋势,但无统计学差异;TIA组患者外周血循环EPCs数量和血清VEGF含量均显著高于非TIA组和正常对照组(均P0.001)。相关分析显示:有或无TIA史的脑梗死患者循环EPCs数量与神经功能缺损严重程度或脑梗死体积均成负相关,而且在TIA组内EPCs数量与血清VEGF含量呈正相关。结论早期外周血循环EPCs数量关系到急性缺血性卒中的严重程度。TIA增加了对循环EPCs的动员,提高了外周血循环EPCs数量,EPCs增加很可能受VEGF调节,这可能是TIA发挥对后继脑梗死保护作用的机制之一。

The changes and value of circulating endothelial progenitor cells levels in cerebral infarct patients with prior transient ischemic attack

Objective To investigate the changes and value of circulating endothelial progenitor cells(EPCs) from peripheral blood in cerebral infarct patients with prior transient ischemic attack(TIA).Methods A total of 58 cases of first ever cerebral infarct patients were consecutively allocated to two groups,that is,TIA group(n=26) and non-TIA group(n=32) based on the presence or absence of prior ipsilateral TIA.16 healthy individuals were included as normal controls.Stroke severity was assessed by certified neurolo...