缺血性脑血管病患者循环内皮祖细胞水平及相关危险因素分析
发布时间：2018-09-09 09:20
【摘要】：目的：应用流式细胞法结合细胞表面标志测定急性脑梗塞和慢性脑缺血患者循环内皮祖细胞(Endothelial progenitor cell,EPC)水平，比较急性脑梗塞患者、慢性脑缺血患者和正常对照组循环EPC水平，分析急性脑梗塞患者循环EPC水平与脑血管病危险因素之间的相关性，分析慢性脑缺血患者循环EPC水平与颈动脉狭窄之间的关系，揭示EPC在缺血性脑血管病研究中的意义。 方法：1.采用CD34+、CD133+和KDR+细胞表面标志鉴定循环内皮祖细胞。分别从25例急性脑梗塞患者发病24小时内和30例慢性脑缺血患者和15例无脑缺血正常人的外周静脉采集静脉血4ml。采用流式细胞计数法测定循环内皮祖细胞数。2.测定25例急性脑梗塞患者循环EPC水平，并收集一般临床资料和检查指标，包括：年龄、收缩压(SBP)、糖化血红蛋白(HbA1c)、总胆固醇(TC)，甘油三酯(TG)、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C)，运用Pearson相关性分析其与循环EPC水平的相关性。3.测定30例慢性脑缺血患者循环EPC水平，采用数字减影血管造影方法测定其颈动脉狭窄程度，，比较不同颈动脉狭窄程度与循环EPC水平的关系，采用颈血管超声检查测定其颈动脉内中膜厚度(CIMT),运用Pearson相关性分析IMT与循环EPC水平的相关性。 结果：1.急性脑梗塞患者和慢性性脑缺血患者相比正常对照组，循环EPC数量明显下降（P＜0.01）；急性脑梗塞患者较慢性脑缺血患者循环EPC数量下降更明显（P＜0.01）。2.急性脑梗塞患者循环EPC水平与收缩压、总胆固醇、低密度脂蛋白呈中度负相关,与糖化血红蛋白、甘油三酯呈低度负相关（P＜0.05）。3.颈动脉轻度狭窄和中重度狭窄患者较正常对照组循环EPC数量下降（P＜0.05），且中重度狭窄患者较轻度狭窄组患者下降更明显（P＜0.05）；慢性脑缺血患者颈动脉内中膜厚度与循环EPC水平呈中度负相关（P＜0.05）。 结论：急性脑梗塞患者和慢性脑缺血患者循环内皮祖细胞数明显降低，循环内皮祖细胞数的降低可能是脑缺血发生的危险因素之一；脑血管危险因素高血压、总胆固醇、低密度脂蛋白、颈动脉狭窄与循环EPC水平之间有密切相关性；EPC对于临床预测、预防和治疗缺血性脑血管性具有重要临床价值和潜力。
[Abstract]:Objective: to determine the level of circulating endothelial progenitor cell (Endothelial progenitor cell,EPC) in patients with acute cerebral infarction and chronic cerebral ischemia by flow cytometry combined with cell surface markers, and to compare the level of circulating EPC in patients with acute cerebral infarction, patients with chronic cerebral ischemia and control group. The relationship between circulating EPC level and risk factors of cerebrovascular disease in patients with acute cerebral infarction was analyzed. The relationship between circulating EPC level and carotid artery stenosis in patients with chronic cerebral ischemia was analyzed. The significance of EPC in the study of ischemic cerebrovascular disease was revealed. Method 1: 1. Circulating endothelial progenitor cells were identified by CD34 CD 133 and KDR cell surface markers. Venous blood was collected from peripheral veins of 25 patients with acute cerebral infarction within 24 hours of onset, 30 patients with chronic cerebral ischemia and 15 normal subjects without cerebral ischemia. Flow cytometry was used to measure the number of circulating endothelial progenitor cells. The level of circulating EPC was measured in 25 patients with acute cerebral infarction, and general clinical data and examination indexes, including age, were collected. Systolic blood pressure (SBP), glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were analyzed by Pearson correlation analysis. The level of circulating EPC was measured in 30 patients with chronic cerebral ischemia. The degree of carotid artery stenosis was measured by digital subtraction angiography, and the relationship between different degree of carotid stenosis and circulating EPC level was compared. Carotid intima-media thickness (CIMT),) was measured by carotid ultrasound. Pearson correlation was used to analyze the correlation between IMT and circulating EPC. The result is 1: 1. The number of circulating EPC in patients with acute cerebral infarction and chronic cerebral ischemia was significantly lower than that in normal controls (P < 0. 01), and the number of circulating EPC in patients with acute cerebral infarction was significantly lower than that in patients with chronic cerebral ischemia (P < 0. 01). The level of circulating EPC was negatively correlated with systolic blood pressure, total cholesterol, low density lipoprotein, glycosylated hemoglobin and triglyceride in patients with acute cerebral infarction (P < 0. 05). The number of circulating EPC in patients with mild and moderate stenosis of carotid artery was lower than that in control group (P < 0. 05), and the number of circulating EPC in patients with moderate and severe stenosis was significantly lower than that in patients with mild stenosis (P < 0. 05). There was a moderate negative correlation between carotid intima media thickness and circulating EPC level in patients with chronic cerebral ischemia (P < 0. 05). Conclusion: the number of circulating endothelial progenitor cells in patients with acute cerebral infarction and chronic cerebral ischemia is significantly decreased, and the decrease of circulating endothelial progenitor cells may be one of the risk factors of cerebral ischemia. There is a close correlation between low density lipoprotein (LDL), carotid stenosis and circulating EPC levels. EPCs have important clinical value and potential for clinical prediction, prevention and treatment of ischemic cerebrovascular disease.
【学位授予单位】：上海交通大学
【学位级别】：博士
【学位授予年份】：2014
【分类号】：R743.3
本文编号：2231968
[Abstract]:Objective: to determine the level of circulating endothelial progenitor cell (Endothelial progenitor cell,EPC) in patients with acute cerebral infarction and chronic cerebral ischemia by flow cytometry combined with cell surface markers, and to compare the level of circulating EPC in patients with acute cerebral infarction, patients with chronic cerebral ischemia and control group. The relationship between circulating EPC level and risk factors of cerebrovascular disease in patients with acute cerebral infarction was analyzed. The relationship between circulating EPC level and carotid artery stenosis in patients with chronic cerebral ischemia was analyzed. The significance of EPC in the study of ischemic cerebrovascular disease was revealed. Method 1: 1. Circulating endothelial progenitor cells were identified by CD34 CD 133 and KDR cell surface markers. Venous blood was collected from peripheral veins of 25 patients with acute cerebral infarction within 24 hours of onset, 30 patients with chronic cerebral ischemia and 15 normal subjects without cerebral ischemia. Flow cytometry was used to measure the number of circulating endothelial progenitor cells. The level of circulating EPC was measured in 25 patients with acute cerebral infarction, and general clinical data and examination indexes, including age, were collected. Systolic blood pressure (SBP), glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were analyzed by Pearson correlation analysis. The level of circulating EPC was measured in 30 patients with chronic cerebral ischemia. The degree of carotid artery stenosis was measured by digital subtraction angiography, and the relationship between different degree of carotid stenosis and circulating EPC level was compared. Carotid intima-media thickness (CIMT),) was measured by carotid ultrasound. Pearson correlation was used to analyze the correlation between IMT and circulating EPC. The result is 1: 1. The number of circulating EPC in patients with acute cerebral infarction and chronic cerebral ischemia was significantly lower than that in normal controls (P < 0. 01), and the number of circulating EPC in patients with acute cerebral infarction was significantly lower than that in patients with chronic cerebral ischemia (P < 0. 01). The level of circulating EPC was negatively correlated with systolic blood pressure, total cholesterol, low density lipoprotein, glycosylated hemoglobin and triglyceride in patients with acute cerebral infarction (P < 0. 05). The number of circulating EPC in patients with mild and moderate stenosis of carotid artery was lower than that in control group (P < 0. 05), and the number of circulating EPC in patients with moderate and severe stenosis was significantly lower than that in patients with mild stenosis (P < 0. 05). There was a moderate negative correlation between carotid intima media thickness and circulating EPC level in patients with chronic cerebral ischemia (P < 0. 05). Conclusion: the number of circulating endothelial progenitor cells in patients with acute cerebral infarction and chronic cerebral ischemia is significantly decreased, and the decrease of circulating endothelial progenitor cells may be one of the risk factors of cerebral ischemia. There is a close correlation between low density lipoprotein (LDL), carotid stenosis and circulating EPC levels. EPCs have important clinical value and potential for clinical prediction, prevention and treatment of ischemic cerebrovascular disease.
【学位授予单位】：上海交通大学
【学位级别】：博士
【学位授予年份】：2014
【分类号】：R743.3
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