内皮祖细胞与脑动脉粥样硬化的相关性研究

黄志新1，2，蔡晋1，朱武生1，马敏敏1

摘要：目的探讨内皮功能紊乱的标志物(内皮祖细胞)与脑动脉粥样硬化的相关性。 方法对131例患者采用流式细胞术检测外周血内皮祖细胞数量及(DSA)评估颅内外脑动脉粥样硬化程度。记录人口统计学资料和血管危险因素，并进行比较分析。结果控制混杂因素后，与对照组相比发生脑动脉粥样硬化组的内皮祖细胞水平显著降低(OR=0.344； 95%CI，0.150～0.792；P=0.012)，其次，多元Logistic回归分析显示，内皮祖细胞计数与脑动脉粥样硬化的部位呈负相关。颅内动脉粥样硬化与内皮祖细胞计数无统计学意义(P> 0.05)。结论内皮祖细胞是脑动脉粥样硬化的较好独立预测因素，内皮祖细胞数量降低与脑动脉粥样硬化存在潜在的病理生理联系。

关键词：内皮祖细胞；脑动脉粥样硬化；内皮功能紊乱

中图分类号：R743R255

基金项目：国家自然基金资助项目(No.81400332、81171099)

通讯作者：马敏敏，E-mail：xfliu2@vip.163.com

收稿日期：(2015-04-09)

Huang Zhixin，Cai Jin，Zhu Wusheng，Ma Minmin

Nanjing General Hospital of Nanjing Military Command，PLA，Nanjing 210002，Jiangsu，China；Shenzhen Nanshan People's Hospital，Guangdong Medical College，Shenzhen 518052，Guangdong，China

Corresponding Author：Ma Minmin(Nanjing General Hospital of Nanjing Military Command，PLA，Nanjing 210002，Jiangsu，China)

Abstract：ObjectiveWe therefore to investigated the relationship between the level of EPCs and the severity of CAD.MethodsEPCs were measured by flow cytometry.Digital subtraction angiography (DSA) was performed on 197 patients to assess intracranial and extracranial cerebral atherosclerosis.The individuals’demographic data，biochemical variables and vascular risk factors were collected in detail，compared and analyzed.ResultsThere was a significant negative correlation between EPCs level and the prevalence of CAD after controlling for confounders (odds ratio，OR=0.344； 95%CI(confidence interval):0.150 to 0.792；P=0.012).Next，multivariate logistic regression showed that only EPCs count was significantly negatively associated with the location of CAD.However，EPCs were not significantly associated with intracranial atherosclerosis (P>0.05). Conciusion EPCs were the strong and independent predictor of the progression of cerebral atherosclerosis even after controlling for traditional risk factors.Therefore，increased EPCs might contribute to delay or prevent the occurrence and development of cerebral atherosclerosis.

Key words：cerebrovascular atherosclerosis；endothelial progenitor cells；endothelial dysfunction

卒中是成人致残致死的主要原因，其中缺血性卒中占87%[1]。脑动脉粥样硬化(CAD)是本病发生发展的主要原因，在动脉粥样硬化的基础上，血管管腔狭窄、闭塞或血栓栓塞，即可引发相应神经功能缺损的症状和体征[2]。而内皮功能紊乱在脑动脉粥样硬化发生中又起着决定性作用[3]。内皮祖细胞(EPCs)在内皮损伤后修复中起决定性作用，是一种新型的内源性血管修复机制[4]。当内皮损伤后，EPCs可以归巢到损伤部位，分泌内皮细胞生长因子及分化为内皮细胞替代损伤的内皮细胞，起保护血管内皮抗动脉粥样硬化作用[5]。循环……