The Clinical And Experiment Study On Endothelial Progenitor Cells And High-sensitivity C-reactive Protein In Cerebrovasculardisease

Cerebrovascular disease(CVD) refers to a variety of cerebral vascular lesions caused by brain lesions,that is,cerebral vascular obstruction or rupture caused by cerebral blood flow circulatory disturbance and functional or structural damage.It is called stroke in clinic,including ischemic cerebrovascular disease accounted for about 80%,intracerebral hemorrhage,subarachnoid hemorrhage and other cerebrovascular disease accounted for 20%.At present,cerebral vascular disease has become a major diseases in.middle-aged and elderly in our country against the health and lives.The mortality of cerebrovascular disease has risen to the first and second place in urban residents,third place in rural areas.According to statistics,every year new cerebrovascular disease nationwide about 200 million people,about 3/ 4 people lost the ability to work to a greater or lesser degree.It bring burden to social and family.Currently,the acute cerebrovascular disease is diagnosed mainly by clinical information and imaging detect.It is still a lack of reliable indicators to judge the degree of cerebrovascular injury early.Therefore,we need to find new treatments of cerebrovascular disease and investigate its risk factors.Endothelial progenitor cells(EPCs) are endothelial cell precursor cells,which not only involved in human embryonic angiogenesis,but also involved in angiogenesis and the process of angiogenesis after birth. Under normal circumstances,Endothelial injury and repair keep in a state of dynamic balance.When the existence of risk factors for cerebrovascular disease,the increased apoptosis of endothelial cells.At the same time,the number of EPCs reduce,the destruction of the integrity of arterial intima,thereby promoting the occurrence of cerebrovascular disease and development.At the same time,EPCs of adult bone marrow can enter into peripheral blood after vascular injury.They can migrate, proliferate,differentiate and integrate into injury parts of the vascular endothelial to participate in the repair of vascular injury.Thus,to clarify the changes of EPCs in cerebrovascular disease and its relationship with CVD risk factors is important to find a new way to prevent and treat CVD,to of great significance.C-reactive protein(CRP) is an acute inflammatory response protein. It has a role of opsonin.It can activate complement,promote phagocytosis and stimulate monocyte tissue factor expression of surface features.As a biomarker CRP has become one of the media of atherosclerosis,we can see a large number of CRP deposition in the inflammatory lesions of intima,,CRP caused vascular endothelial cell injury and dysfunction by activating inflammatory cells. High-sensitivity C-reactive protein(hs-CRP) is more sensitive than CRP in detection of low-level inflammatory information.This experiment is to investigate the correlation between the number of EPCs and hs-CRP concentration in peripheral blood of patients with acute cerebrovascular disease.We choose 58 patients with acute cerebrovascular disease as subjects(12 patients with cerebral hemorrhage,46 patients with cerebral infarction),22 healthy persons (control group) as control.The collection of patient age,sex,height, abdominal circumference,smoking history,family history of coronary heart disease,cerebrovascular disease,kidney disease,history of hypertension and diabetes and other clinical data in general.Two millilitre peripheral anticoagulant elbow venous blood were collected after 1,7,14,21 days.Marked EPCs with CD133-PE,KDR-APC fluorescent antibody and detect the number of CD133/KDR double positive cells by flow cytometry.At the same time,hs-CRP concentration were detectd by using immunological transmission Turbidimetry.Using 7-170s full automatic biochemical analyzer to detect the level of high density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),triglycerides(TG),total cholesterol(TC),blood glucose,blood urea nitrogen,creatinine and uric acid.Experimental results show that: 1.It is no significant difference(P＞0.05) in age and sex between cerebrovascular disease group and healthy control group.Abdominal circumference,weight index,blood pressure,heart rate,blood glucose, creatinine,blood urea nitrogen,cholesterol,triglycerides,urine acid in cerebrovascular disease group were significantly higher than healthy control group.It indicated that danger factors cerebrovascular disease is related to the occurrence of cerebrovascular disease.2.The number of EPCs in cerebrovascular disease group were lower than the healthy control group(P＜0.05).In the development course of disease,the number of EPCs were dynamic changes,it decreased from 1 day to 14 days continually.It begin to rise at 21days,but still lower than the initial level of incidence.The results were consistent with pathological features of ischemic cerebrovascular disease.There were significantly difference(P＜0.05) in the number of EPCs among light, medium and heavy of cerebrovascular diseases group.The more serious, the less number of EPCs,there were negative correlation between them. The results show that changes of the number of EPCs may be used to predict the course,the severity and prognosis of cerebrovascular disease.3.Hs-CRP concentrations in serum in Cerebrovascular disease group was significantly higher than the healthy control group(P＜0.05).With the development of disease,hs-CRP concentration also show the dynamic changes.It decreased continually from 1 day to 14 days.It begin to rise at 21days,but still lower than the initial level of incidence.The results were related with pathological features and clinical treatment of disease.There were significantly difference(P＜0.05) in hs-CRP concentration among light,medium and heavy of cerebrovascular diseases group.The more serious of cerebrovascular disease,the more higher of hs-CRP concentration.The results suggested that cerebrovascular disease may be associated with inflammatory diseases.4.The number of EPCs and the concentration of hs-CRP was negatively correlated in cerebrovascular disease group.It show that hs-CRP participate in inflammatory process may be related to the number of EPCs reduce.5.Cerebrovascular disease risk factors(including smoking history, history of hypertension,systolic blood pressure,TC,TG) were the major factor affecting the number of EPCs,it was a negative correlation between them.Systolic blood pressure and low-density lipoprotein is the independent factors affecting the number of EPCs,systolic blood pressure was an important risk factor,affecting the incidence and prognosis of cerebrovascular disease.This experiment clarified the changes rule of the number of EPCs and hs-CRP concentrations at different time points and different serious degrees in pathogenesis of cerebrovascular disease.We also investigate the relationship between the number of EPCs and cerebrovascular disease risk factors.All of them will provide not only new targets for cerebrovascular disease treatment but also the theoretical and experimental basis about new pathway for prevention and treatment of CVD.