| Objective: We observed the dynamic changes on the peripheral blood monocyteproportion and monocyte count in patients with acute cerebral infarction (ACI), as wellas the relationship with the serum level of C-reactive protein (CRP) and the degree ofneurologic deficits，to study the role of the monocyte in ACI and its possiblepathophysiological mechanisms. The effect of berberine hydrochloride and atorvastatincalcium on the peripheral blood monocyte proportion and monocyte count in patientswith ACI is further measured，and then studied the effect and the pathophysiologicalmechanism of berberine hydrochloride and atorvastatin calcium in ACI.Method: Healthy check-up of75cases were selected for control group and119patients with ACI were selected for cerebral infarction (CI) group, the patients of CIgroup satisfied the inclusion criteria and exclusion criteria, and two groups werecomparable in age, gender composition.The CI group was further randomly divided intothe standard group (51cases), the berberine group (32cases) and the statin group (36cases) by the control study. The three groups were comparable in age, gendercomposition and the severity of disease.We measured the peripheral blood monocyteproportion and monocyte count by the Japanese Sysmex XE automated haematologyanalyser and the compatible reagent. The serum level of CPR (mg/L) was measured byrate nephelometry.We observed the change of the peripheral blood monocyte proportionand monocyte count (×109/L) respectively within48hours of onset (before thetreatment) and on the first10days after admission (after the treatment) in CI group. Theneurologic deficits degree in CI group was evaluated by the national institutes of healthstroke scale (NIHSS) before and after the treatment. The first data were marked as “1”while the second date were marked as “2”, and “1subtract2” was marked as “D-value”. All date were analyzed by SPSS20.0statistics software. The significance level forbilateral test was less than0.05(P＜0.05).Results:1. The peripheral blood “monocyte proportion”1of the CI group (6.30±2.44) wereslightly lower than that of the control group (6.61±2.76),“monocyte count”1of the CIgroup (0.44±0.18) was slightly higher than that of the control group (0.40±0.18), butthere were no significant differences. The peripheral blood “monocyte proportion”2(7.53±2.21) and “monocyte count”2(0.50±0.20) of the CI group were significantlyhigher than that of the control group (P <0.05, P <0.01).. In the CI group, the peripheralblood “monocyte proportion”2and “monocyte count”2were significantly higherrespectively compared with “monocyte proportion”1and the “monocyte count”1(P<0.01, P <0.01).2. In the CI group, the peripheral blood “monocyte proportion”1and “monocytecount”1showed no significant correlation with the twice NIHSS scores (4.07±2.46,2.58±2.34) and the NIHSS D-value (1.49±2.00). There was no significant correlationbetween “monocyte proportion”2and NIHSS2, while there was a significant positivecorrelation between “monocyte count”2and NIHSS2(r=0.238, P<0.05). But nosignificant correlation was found respectively between the monocyte proportionD-value, the monocyte count D-value and the twice NIHSS scores, the NIHSS D-value.3. In the CI group, the twice peripheral blood monocyte proportion showed nosignificant correlation with the twice serum CRP level (2.47±3.40,3.47±5.27). Themonocyte proportion D-value showed a significant negative correlation with CRP2(r=-0.233, P<0.05), and a significant a significant positive correlation with CRP D-value(-0.96±6.08)(r=0.257, P<0.05), but no significant correlation with CRP1. In the CIgroup, the peripheral blood “monocyte count”1showed a significant positive correlationwith CRP1(r=0.285, P<0.01), while no significant correlation was found with CRP2and CRP D-value. The “monocyte count”2showed a significant positive correlationwith CRP2(r=0.228，P<0.05), while no significant correlation was found with CRP1and CRP D-value. The monocyte count D-value showed a significant positivecorrelation with CRP D-value (r=0.245, P<0.05), while no significant correlation wasfound with CRP1and CRP2.4. Before the treatment, the peripheral blood monocyte proportion (6.52±2.28,6.06±2.07,6.57±2.80), the monocyte count (0.47±0.19,0.43±0.13,0.43±0.20) and theNIHSS score (4.16±2.50,4.34±3.01,3.69±1.82) had no significant difference among the standard group, the berberine group and the statin group. In the standard group, theperipheral blood monocyte proportion and monocyte count after the treatment(8.13±2.33,0.52±0.18) were significant increased than that before the treatment (P<0.01,P<0.05). In the statin group, the peripheral blood monocyte proportion and monocytecount after the treatment (7.52±1.82,0.50±0.20) were significant increased than thatbefore the treatment.(P<0.05, P<0.05). In the berberine group, the peripheral bloodmonocyte proportion and monocyte count after the treatment (6.73±2.15,0.47±0.24)were slightly increased than that before the treatment.The NIHSS scores of the standardgroup, the berberine group and the statin group after the treatment (3.00±2.70,2.53±1.72,2.03±2.20) were significant decreased than that before the treatment (P<0.01,P<0.01, P<0.01).Conclusion:1. The peripheral blood monocyte proportion and monocyte count in patients withACI increased significantly. It indicated that the monocyte might participate in thepathophysiologic process of ACI.2. The peripheral blood monocyte count in patients with ACI was able to reflectthe severity of the disease. The higher the monocyte count, the higher the degree ofneurologic deficits.3. The peripheral blood monocyte count in patients with ACI was able to reflectseverity of the inflammatory response of CI. The higher the peripheral blood monocytecount, the more serious of the inflammatory response of CI. The monocyte may beclosely associated with the inflammatory response process of ACI.4. The berberine hydrochloride was able to inhibit the peripheral blood monocyteproportion and monocyte count in patients with ACI while the atorvastatin calciumwasn’t. It indicated that took the berberine hydrochloride might get more beneficial thanthe atorvastatin calcium for the patients with ACI. |
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