The Study Of Changes Of Circulating EPCs In Patients With Carotid Stenosis

Objecitve:Carotid stenosis(CS) and occlusion is one of the most familiar senile diseases,atherosclerotic plaque of carotid artery is the main reason that lesds to CS and occlusion,which may cause ischemic cerebrovascular disease(CVD).Endothelial progenitor cells(EPCs) not only participate in angiogenesis in embryo stage,but also have effects in postnatal stage.When the tissue has an ischemia,EPCs would become active in vessel neogenesis,play an important role in lessening endomembrane thickening and reablement of impaired vessel in the process of vessel repairing.This study select the case according to the results of ultrasound,and flow cytometer was used to identify EPCs.We intended to investigate the quantity of circulating EPCs in CS patients,and study the role of EPCs in the development of CS.We desired to provide an evidence for treating ischemic CVD by EPCs.Methods:The objects of this study divid into two groups.The research group was made up of CS patients which were seprated by ultrasound to mild(n=17)and severe(n=18) groups with CS.All of the 35 cases were in Neurology Department of the hospital during the period from June 2008 to October 2008.The control group, made up of 20 healthy persons,was selected from the examination center of the hospital at the same time.The gender and age of the two groups are matched.All of the cases were taken blood pressure,and had a brain scan.Then they had an ultrasound of carotid arteries.We would examine Intima-media thickness(IMT) of double common carotid arteries,carotid bifureation and internal carotid arteries,the morphological and histological character of plaque,and the degree of CS.After that they would be phlebotomized from ulnar vein on an empty stomach.We would has results of blood routine examination,blood-fat and the quantity of circulating EPCs. Mononuclear cells were isolated by density gradient centrifugation,and flow cytometer was used to identify EPCs.All the deta were analysed by SPSS16.0 software.They were statisticed difference when P＜0.05,α=0.05.Results:1.The value of IMT is 2.74±1.05mm in patients,and 1.72±0.96mm in control group.The level of IMT in patients was higher than in control group(P＜0.005).We detected atherosclerotic plaque in all patients which was especially happened in two sides.The rate of detection was 58.2%in CB,which was higher than the onset of ICA(23.1%).The features of atherosclerotic plaque in mild group were as follows:9/17 with the hard plaque,3/17 with the soft-plaque,5/17 with the commixing plaque.The features of atherosclerotic plaque in severe group were as follows:3/18 with the hard plaque,10/18 with the soft-plaque,5/18 with the commixing plaque.2.There was an decreasing tendency about PSV and EDV in severe group as compared with that in mild and control group(P＜0.01);there was an increasing tendency about RI in severe group as compared with that in mild and control group(P＜0.05);there was an decreasing tendency about PSV and EDV and increasing tendency about RI in mild group as compared with that in control group, but no difference(P＞0.05).3.The quantity of EPCs in all cases exhibit a negative correlation with age,systolic pressure,diastolic pressure,triglyceride,cholesterol and low density lipoprotein(P＜0.01),but no correlation with gender and high density lipoprotein(P＞0.05).Among them,systolic pressure and low density lipoprotein were independent factor influencing the quantity of EPCs.4.The quantity of EPC were 21.59±6.24 in mild group,37.31±6.91 in severe group and 93.71±8.13 in control group,and there was difference between them(P＜0.01).Conclusions:1.Thickening of IMT is a reliable indicator to diagnose atherosclerosis.2.The main occurring place of atherosclerotic plaque was CB, secondly for onset of ICA which were especially happened in two sides.The plaque was mostly hard plaque in mild stenosis and soft-plaque in severe stenosis.3.There was a high rate of inducing hemodynamic changes in severe stenosis.4.Systolic pressure and low density lipoprotein were independent factor influencing the quantity of EPCs.5.There is no correlation between the quantity of EPCs and the level of CS.Innovation:The study use flow Cytometer toidentify EPCs.We try to analyse the correlation between the quantity of EPCs and the level of CS for the first time in China.