The Effect And Clinical Significance Of Bone Marrow Stem Cells Mobilization On Peripheral Blood MCV、RDW-CV And Relevant Parameters Levels In Patients With Cerebral Infarction

Objective: To observe the dynamic changes of mean corpuscular volume（MVC），red blood cell distribution width coefficient of variability（RDW-CV）and relatedparameters in peripheral blood and the degree of nervous functional defect in patientswith cerebral infarct，to further investigate the effects of bone marrow stem cellmobilization on all of these indexes．To study the relation of MCV，RDW-CV，relatedparameters and the degree of nervous functional defect and its significance．To observedthe effects of bone marrow stem cell mobilization on cerebral infarct and its clinicalapplication and the possible pathophysiologic mechanism．Method:42healthy persons as control group and65cases with cerebral infarctionas case group were selected．A total127cases of patients match the inclusion andexclusion Standard．Two groups in age and gender composition were comparable．Byapplying control study，case group were randomly divided with into two groups (35inconventional treatment group，30in stem cell mobilization group）．Two groups in age，gender and severity of ill condition were comparable．Use COULTER-sysmex XEBlood Cell Analysis and reagents determining the level of MCV（fL），RDW-CV（%），red blood cell（RBC）count（1012/L），hemoglobin（HB）（g/L）and hematocrit（HCT）（L/L）in peripheral blood．Hitach autobiochemistry instrument was used to testthe level of alanine aminotransferase（ALT）（by rate method，U/L），aspartateaminotransferase（AST）（by rate method，U/L），Urea（by urease UV-rate method，mmol/L），creatinine（Cre）（by HMMPS method，μmol/L），alkaline phosphatase（ALP）（by AMP buffer method，U/L），and creatine kinase（CK）（by DGKG method，U/L）in peripheral blood in case group．The changes of these parameters were observedbefore and after treatment，and the adverse reactions were also recorded．They were assessed with National Institute of Health stroke scale（NIHSS）to test the degree ofnervous functional defect in case group before and after treatment．The first test（beforetreatment）referred to as "1"，the second（after treatment）referred to as "2"，and theD-value was referred to the result of “1” subtract “2”．All data using SPSS20.0statistical software for statistical processing，and a significant test of the standard wastest for bilateral P<0.05．Results:1．The MCV2（89.695±5.419）levels of peripheral blood in the case group wasmarkedly lower than that in the control group（92.187±4.139）（P＜0.05），theRDW-CV2（13.497±1.182）levels was markedly higher than that in the control group（12.957±0.901）（P＜0.05）．The peripheral blood level of MCV1（90.836±5.031），RDW-CV1（13.048±1.123），RBC1（4.489±0.547），RBC2（4.351±0.508），HB1（134.969±18.596），HB2（130.449±17.353），HCT1（0.408±0.050）and HCT2（0.389±0.045）in the case group and the level of control group（RBC：4.398±0.392，HB：134.238±11.773，HCT：0.403±0.039）compared the not obvious difference．2．The peripheral blood level of MCV1revealed a significant inverse correlationwith the level of RBC1and RBC2（r=-0.257，P＜0.05；r=-0.315，P＜0.05），and notwith the level of HB1，HB2，HCT1and HCT2in case group．The peripheral blood levelof MCV2revealed a significant inverse correlation with the level of RBC2（r=-0.279，P＜0.05），and not with the level of RBC1，HB1，HB2，HCT1and HCT2in casegroup． The peripheral blood level of RDW-CV1revealed a significant inversecorrelation with the level of HB1（r=-0.292，P＜0.05），and not with the level of RBC1，RBC2，HB2，HCT1and HCT2in case group．The peripheral blood level of RDW-CV2and the level of RBC1，RBC2，HB1，HB2，HCT1and HCT2had no significantcorrelation in case group．3．The peripheral blood level of MCV1revealed a significant inverse correlationwith the score of NIHSS1（2.880±2.997）and NIHSS2（2.460±2.884）（r=-0.260，P＜0.05；r=-0.266，P＜0.05），the correlation coefficients between the level of MCV2and the results of two NHISS evaluations were negative，means there were negativecorrelation trend between them，but it had no significance in statistics．The peripheralblood level of MCV2，RDW-CV1，RDW-CV2，RBC1，HB1，HB2，HCT1，HCT2and the results of two NHISS evaluations had no significant correlation．4．By comparing the conventional treatment group and the stem cell mobilizationgroup: before treatment there was no obvious significance in the score of NIHSS1 （2.570±3.051，3.230±2.944），MCV1（89.453±6.545，91.907±3.444），RDW-CV1（13.204±1.393，13.047±0.907）、RBC1（4.495±0.503，4.426±0.565），HB1（132.075±18.419，135.230±17.684）and HCT1（0.402±0.050，0.407±0.047）between two groups．The value of the diffidence of NIHSS（0.030±0.747）inconventional treatment group was markedly lower than that in the stem cellmobilization group（0.870±1.432）（P＜0.01），the peripheral blood level of MCV2（87.507±6.699）was markedly lower than that in the stem cell mobilization group（91.650±3.047）（P＜0.01），the value of the diffidence of MCV was markedly higherthan that in the stem cell mobilization group（0.257±1.801）（P＜0.01），the absolutevalue of the diffidence of RDW-CV was markedly lower than that in the stem cellmobilization group（-0.590±0.429）（P＜0.05）．The NHISS2（2.540±3.275，2.370±2.399）evaluation，RDW-CV2（13.392±1.488，13.633±0.854），RBC2（4.380±0.500，4.327±0.532），the value of the diffidence of RBC（0.127±0.235，0.109±0.208），HB2（128.479±17.788，132.370±17.318），the value of the diffidenceof HB（3.596±6.760，2.860±6.454），HCT2（0.384±0.047，0.395±0.044）and thevalue of the diffidence of HCT（0.019±0.022，0.012±0.021）compared the not obviousdifference between two groups．Comparing with those before treatment in conventional treatment group: theperipheral MCV level was decreased significantly after treatment（P＜0.01），theperipheral RBC，HB and HCT level were decreased significantly after treatment（P＜0.05，P＜0.01，P＜0.01）．The NIHSS evaluation was decreased and the peripheralblood RDW-CV level was increased after treatment，their difference had no statisticssignificance．Comparing with those before treatment in stem cell mobilization group：the NIHSSevaluation was decreased significantly after treatment（P＜0.01），the peripheral bloodRDW-CV level was increased significantly after treatment（P＜0.01），the peripheralblood RBC，HB and HCT level were decreased significantly after treatment（P＜0.05，P＜0.05，P＜0.01）．The peripheral blood MCV level was decreased after treatment andits difference had no statistics significance．5． No major adverse events were observed in the stem cell mobilizationgroup．There was no obvious main complaint about side effects during the period oftreatment．A few patients have symptoms such as hip pain（two case），anorexia（twocase）and nausea（1case），occurred in second day after stem cell mobilization treatmentwith low-level．The patient’s symptoms resolved after treatment in the next day． By comparing the conventional treatment group and the stem cell mobilizationgroup with the level of liver and renal functional parameters，ALP and CK：There wasno obvious significance in the level of ALT1（17.217±10.531，25.167±29.235），AST1（16.087±4.420，21.000±12.003），Urea1（5.894±1.837，5.952±1.688），Cre1（67.546±22.679，69.467±16.322），ALP1（73.217±25.357，77.833±19.403），CK1（74.389±37.156，81.074±35.071）before treatment between two groups．Theperipheral blood level of ALT2（17.087±6.598）was markedly lower than that in thestem cell mobilization group（25.600±20.135）（P＜0.05），the peripheral blood levelof AST2（17.957±6.725）was markedly lower than that in the stem cell mobilizationgroup（28.400±19.172）（P＜0.01），ALP2（75.000±23.485）and the value of thediffidence of ALP（-1.783±8.034）was markedly lower than that in the stem cellmobilization group（149.467±51.118，-71.633±44.403）（P＜0.01，P＜0.01），theperipheral blood level of Urea2（4.956±1.362）was markedly higher than that in thestem cell mobilization group（4.023±1.106）（P＜0.01），the value of the diffidenceof Urea（0.938±1.912）was markedly lower than that in the stem cell mobilization group（1.929±1.209）（P＜0.05），the value of the diffidence of Cre（9.409±11.738）was markedly higher than that in the stem cell mobilization group（2.633±9.565）（P＜0.05）．The value of the diffidence of ALT（0.130±10.315，-0.433±19.141），the value of the diffidence of AST（-1.870±7.021，-7.400±19.064），Cre2（58.136±16.488，66.833±14.830），CK2（61.833±36.160，58.074±36.601）and the valueof the diffidence of CK（12.556±29.998，23.000±40.512）compared the not obviousdifference between two groups．Comparing with those before treatment in conventional treatment group: theperipheral blood Urea and Cre level was decreased significantly after treatment（P＜0.05，P＜0.01）．The peripheral blood AST and ALP level were increased and theperipheral blood ALT and CK level were decreased after treatment，their difference hadno statistics significance．Comparing with those before treatment in stem cell mobilization group: theperipheral blood AST and ALP level was creased significantly after treatment（P＜0.05，P＜0.01），the peripheral blood Urea and CK level was decreased significantlyafter treatmen（tP＜0.01，P＜0.01）．The peripheral blood ALP level was increased andthe peripheral blood Cre level was decreased after treatment，their difference had nostatistics significance．Conclusion: 1．The peripheral blood MCV level was obviously lower and the peripheral bloodRDW-CV level was obviously higher in patients with cerebral infarct，suggested thatthey could take part in the pathophysiological procedure of cerebral infarct．2．The peripheral blood MCV level was closely related to the peripheral bloodRBC count level with cerebral infarction in patients，the RBC count level lower，theMCV level is higher．The peripheral blood RDW-CV level was closely related to theperipheral blood HB level，the HB level lower，the RDW-CV level is higher．3．The peripheral blood MCV and RBC count level reflect the severity of cerebralinfarction，the lower of peripheral blood the MCV level，the severer the degree ofneurological dysfunction，while the latter is on the contrary．The peripheral bloodRDW-CV level can not reflect the severity of cerebral infarction．4．Bone marrow stem cell mobilization can obviously restrain the decrease of theperipheral blood MCV level，significantly increase the peripheral blood RDW-CV leveland effectively reduce the degree of neural function damage on cerebral infarction．Theinfluence of the peripheral blood MCV level should have a positive effect on improvingthe prognosis．5．Bone marrow stem cell mobilization may have mild liver damage and nodamage effect on kidney function and striated muscle in patients with cerebralinfarction．...