外周血CD133＋细胞在急性脑梗死患者中的表达及意义

目的：探讨急性脑梗死患者外周静脉血CD133＋细胞的表达情况及其与神经功能缺损和梗死体积的相关性；评估CD133＋在预测脑卒中高危因素中的价值。方法总检测90例样本，其中急性脑梗死患者60例（脑梗死组），有脑血管危险因素但无脑梗死发生的住院患者30例（对照组）。以CD133＋细胞作为内皮组细胞（EPC）标记，采用流式细胞仪测定发病72 h以内的EPC数量，并分别记录脑梗死组患者神经功能缺损评分和梗死病灶体积。根据TOAST病因分型将患者分为5型：大动脉粥样硬化型（LAA）、心源性栓塞型（CE）、小动脉闭塞型（SAA）、其他明确病因型（SOE）、不明原因型（SUE）。结果与对照组比较，脑梗死组患者外周血CD133＋细胞百分比减低，差异有统计学意义（P＜0.05），且脑梗死组患者外周CD133＋细胞百分比与神经功能缺损评分（NIHSS评分）呈明显负相关（r=-0.787，P＜0.01）；与梗死病灶体积呈负相关（r=-0.746，P＜0.01），脑梗死各病因分型的外周血CD133＋细胞水平均高于对照组（P＜0.01）；SAA型中外周血CD133＋细胞水平高于LAA型、CE型（P＜0.01），LAA型与CE型相比差异无统计学意义（P＞0.05）。结论在脑缺血急性期，患者外周血CD133＋细胞水平明显降低，且急性脑梗死患者外周血CD133＋细胞水平与神经功能缺损程度、梗死灶体积有关。CD133＋水平具有预测缺血性脑卒中神经功能损伤程度的价值。

Expression and Significance of the Level of Peripheral Blood CD133 Positive Cells in Patients with Acute Cerebral Infarction

Objective To evaluate the expression and clinical significance of the level of peripheral blood CD133＋cells in patients with acute cerebral infarction;To investigate the hypothesis that the level of circulating CD133 positive is predictive of risk factors for ischemic stroke. Methods A total of 90 individuals were examined, including 60 patients with acute cerebral infarction （infarct group, n=60）, 30 patients with cerebrovascular risk factors （control group, n=30）. The EPC was marked by CD133＋. The level of peripheral blood CD133＋ cells was determined by flow cytometry within 72 hours of onset of patients. The neural function defect score and infarction lesion volume were determined in patients with infarction group. According to TOAST criteria, all the patients were classified into five subtypes：LAA, CE, SAA, SOE and SUE. Results Compared with control group, the percentage of peripheral blood CD133＋cells in infarction patients is lower than that in the control group, the difference was statistically significant （P〈0.05）. And the percentage of CD133＋cells in peripheral blood of patients with neurologic impairment score was negatively correlated （r=-0.755, P〈0.01）. The percentage of peripheral blood CD133＋cells with different infarct lesion volume in infarction patients is significantly lower than that in the control group, the difference was statistically significant （P〈0.05）. The level of peripheral blood CD133＋cells in patients with SAA is highest among groups with respect to classification of stroke etiology （P〈0.01）. Conclusion The number of peripheral blood CD133＋ cells has correlation with the risk factors of cerebrovascular infarction. In cerebral ischemia, the level of peripheral blood CD133＋ cells is significantly reduced and its level is related to neurologic impairment and infarction volume. The level of circulating CD133＋was predictive of neurological impairment.