Association Between Phlegm-dampness Or Blood-stasis Constitution Of TCM And Circulating Endothelial Progenitor Cells In Cerebral Atherosclerosis Patients

Objects:The aim of the study is to investigate the association between circulating endothelial progenitor Cells(EPCs)and cerebral atherosclerosis(CAD)in 40～65 years old patients with phlegm-dampness or blood-stasis constitution of TCM,and explore new combined strategy of Chinese traditional medicine and modern western medicine for CAD.Methods:The study prospectively enrolled 40～65 years old patients with phlegm-dampness constitution,blood-stasis constitution and mild constitution who were admitted in the department of Neurology Fujian Provincial Hospital,from Feb,2016 to Feb,2017.TCM constitution questionaire was used to identify the constitution.Cerebral atherosclerosis screening and evaluation of diagnostic standards(2014 edition)was used to identify cerebral atherosclerosis.Patients with mild constitution and without CAD were included in the control group.Cerebral atherosclerosis patients with phlegm-dampness constitution and blood-stasis constitution were included in the experimental group.Counts of EPCs were measured by flow cytometry.The demographic data and vascular risk factors were compared and analyzed.ROC analysis was used to evaluate the value of EPCs in diagnosis of cerebral atherosclerosis.Results:1.A total of 120 patients were enrolled,including 46 cases with hlegm-matter constitution,49 cases with stasis matter constitution,95 cases with cerebral atherosclerosis(CAD group),and 25 cases without cerebral atherosclerosis(control group).The numbers of patients with mild and severe cerebral atheroclerosis were 62 and 33,respectively.There were 44 females subjects in the study(36.67%).The mean age was(53.5±6.7)years old.The incidence of hypertension and hyperlipidemia,which were two most important risk factors for CAD,was 70.00%and 44.20%,resectively.2.The results of multinomial Logistic regression confirmed that hypertension was an independent predictor of phlegm-dampness constitution and blood-stasis constitution.The number of circulating EPCs was correlated negatively with CAD with blood-stasis constitution.And CAD with blood-stasis constitution were common in patients with previous history of stroke/TIA.3.Factors associated with CAD were analyzed by logistic regression and showed that high counts of circulating EPCs was a protective factor for CAD.However,old age and hypertension were risk factors for CAD.And Most patients with previous history of stroke/TIA had CAD.4.The results of Logistic regression showed that the numbers of circulating EPCs was correlated negatively with CAD.Furthemore,blood-stasis constitution was an independent predictor of severe cerebral atheroclerosis.5.ROC analysis showed that the number of circulating EPCs can reliably identify cerebral atherosclerosis with the optimal diagnostic value of 0.115%.Conclusions:1.Higher circulating EPCs number is a protective factor of atherosclerosis.While the mechanism underlie this remain unclear.Injury-induced endothelial regeneration may be involved in this process.2.The numbers of circulating EPCs was correlated negatively with Blood-stasis constitution in cerebral atherosclerosis patients.Blood-stasis constitution is an independent risk factor for cerebral atherosclerosis,and its mechanism may be related to the abnormity of haemodynamics and blood coagulation.Not yet found the association between phlegm-dampness constitution of TCM and circulating endothelial progenitor cells in cerebral atherosclerosis patients.