| Atherosclerosis (AS) is an important pathological basis of Ischemic stroke, it is known to all that damage endothelial cell function and dysfunction are the key of atherosclerotic disease, currently, there is lack of cytological markers of early vascular endothelial function in patients with ischemic stroke. Research has shown that CD34~+ cells are endothelial progenitor cells, determined the level of CD34~+ cells may reflect changes in endothelial function. Therefore, the level of peripheral blood CD34~+ cells could as a cytological markers of early vascular endothelial function in patients with ischemic stroke. Carrying out the detection of the level of peripheral blood CD34~+ cells in patients with carotid atherosclerosis (CAS),can predict the severity of atherosclerosis, make diagnosis and prognosis evaluation of early vascular lesion, and guidance to patients with vascular lesion and early target organ damage to adopt a intervention measure as soon as possible or increase the treatment measures of the level of peripheral blood CD34~+ cells to improve the repair of endothelial function in patients with acute cerebral infarction and inhibit or delay the process of atherosclerosis, target organ protection has a positive meaning.There are a large number of reports at home and abroad, the number of peripheral blood CD34~+ cells significantly increased in patients after acute myocardial infarction, but there is few reports on the determination of the level of peripheral blood CD34~+ cells in patients with acute cerebral infarction(ACI), and it has not seen the related reports which on the level of peripheral blood CD34~+ cells and carotid atherosclerosis at home. In this study, determining the level of peripheral blood CD34~+ cells with flow cytometry within 72 hours of onset of acute cerebral infarction (ie, infarct group), with cerebrovascular risk factors in patients without cerebral infarction (ie, high-risk group) and healthy hospital over the same period (ie, control group), comparing the level of peripheral blood CD34~+ cells, and analyze its relationship with degree of neurological deficit, infarct lesion volume and carotid artery atherosclerosis in the correlation to explore the clinical significance of peripheral blood CD34~+ cells in ischemic brain injury.Study selection and exclusion criteria in accordance with collection in August 2010 ~ January 2011 in Union Hospital of Jilin University in the Department of Neurology at the hospital within 72 hours of onset of acute cerebral infarction (ie, infarction group) 45 cases, with cerebrovascular risk factors patients without cerebral infarction (ie, high-risk group) 27 cases, and the same period healthy patients (ie, control group) 20 cases as research subjects. All cases are in line with the National Conference on the Fourth Amendment cerebrovascular disease diagnostic criteria, and by history,CT and (or) MRI examination confirmed. Infarction group according to the Chinese Stroke Scale in patients with neurological deficit scores: 0 to 15 are divided into groups with mild neurological deficits; 16 to 30 are divided into groups with moderate neurologic impairment; 31 to 45 are severe neurological deficit group; Infarction patients according to Pullicino formula (length×width×CT or MRI scans positive layers/2) calculated infarct lesion volume, and divided into small, medium, and big hearths three groups, <5 cm~3 for the small focal group, 5 ~ 10 cm~3 in the kitchen for the group,>10cm~3 for the big hearths group; Infarction patients were confirmed carotid atherosclerosis (CAS) by carotid ultrasound, according to the severity into three groups: group of carotid artery intimal thickening (A sub-group), carotid artery plaque group (B sub-group) and carotid stenosis group (C sub-group). Determined by flow cytometry all levels of peripheral blood CD34~+ cells were compared the level of peripheral blood CD34~+ cells in each group and analyze its relationship with degree of neurological deficit, infarct lesion volume and carotid artery atherosclerosis in the correlation, and the results were statistically analyzed.The results showed that:①the percentage of peripheral blood CD34~+ cells in infarction patients is lower than which in high-risk group, while the percentage of peripheral blood CD34~+ cells in high-risk group is also lower than which in the control group, the difference was statistically significant (p<0.05).②the percentage of peripheral blood CD34~+ cells with different degree of neurological deficit in infarction patients is significantly lower than the control group, the difference was statistically significant (p<0.05); Among them, the heavy percentage of peripheral blood CD34~+ cells is lower than the moderate group, while the moderate percentage of peripheral blood CD34~+ cells is lower than the mild group, the difference was statistically significant (p<0.05). In infarction group, the study also found that the percentage of CD34~+ cells in peripheral blood of patients with neurologic impairment score was negatively correlated (r =-0.721, p<0.01).③the percentage of peripheral blood CD34~+ cells with different infarct lesion volume in infarction patients is significantly lower than the control group, the difference was statistically significant (p<0.05); Among them, the stove percentage of peripheral blood CD34~+ cells group is lower than group in the kitchen, while the kitchen percentage of peripheral blood CD34~+ cells group is lower than the small focal group, the differences were statistically significant (p<0.05).④A,B and C sub-group patients the percentage of peripheral blood CD34~+ cells is lower than the control group. Where, the percentage of peripheral blood CD34~+ cells in C sub-group is lower than the B sub-group, while the percentage of peripheral blood CD34~+ cells in B sub-group is lower than the A sub-group, the differences were statistically significant (p<0.05). The study also found that the percentage of peripheral blood CD34~+ cells and carotid artery-medial thickness (IMT) was significantly negatively correlated (r=-0.695, p<0.01).In summary, the following conclusions:①In cerebral ischemia, the level of peripheral blood CD34~+ cells is significantly reduced, so that it can be a reflection of a sensitive early indicators of cerebral ischemia;②In patients with acute cerebral infarction the level of peripheral blood CD34~+ cells and neurological deficits and infarct volume, suggesting that it may be used as a sensitive index which reflect the severity of ischemic brain injury.③In patients with acute cerebral infarction the level of peripheral blood CD34~+ cells and carotid atherosclerosis severity, suggesting that it could be used as an objective indicator which judge the severity of carotid artery atherosclerosis.④the level of peripheral blood CD34~+ cells can reflect changes in endothelial function, so that it can be used as cytological markers which reflect early vascular endothelial function in patients with ischemic stroke.
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