| Background:Acute cerebral infarction(ACI)is the oxygen to brain ischemia necrosis,which is due to the reduce of cerebral blood supply or interruption,the result is corresponding brain cells continuous ischemia and permanent death.Earlier studies confirmed that vascular endothelial injury was the pathological basis of cerebrovascular disease.Circulating endothelial cells(CECs)is from endothelial cell damage and fall out,the change of its number can reflect the degree of vascular endothelial damage.Existing researchs showed that the number of CECs significantly increased during ischemia and blood vessel damage disease(such as centrifuge infarction,vasculitis and vascular disease)in the peripheral blood.The vascular endothelial injury is the pathological basis of cerebral infarction,therefore we speculate that in the acute phase of acute cerebral infarction,the levels of CECs may be changed with the development of the course of disease.Due to the degree and scope of vascular damage can reflected by CECs,so we speculate that the levels of CECs in peripheral blood may be appeared different among patients with different range of cerebral infarction area.Objectives:1 The aim of the present study was to observe the change of CECs level in the peripheral blood in patients with acute cerebral infarction.2 The purpose of this study was to discuss the relationship between the number of CECs in the peripheral blood and the size of cerebral infarction area.Methods:The object of study: ACI group: 46 patients with acute cerebral infarction,who were hospitalized in the First Hospital of Shijiazhuang City during November 2014 to June 2015,were taken as an object of studying.The content of CECs in peripheral venous blood was tested onset the 1th day and the 7th day.Normal control group: at the same time of 17 cases of healthy people were randomly selected,those cases were taken peripheral blood on an empty stomach to test the number of CECs.The ACI group patients according to the infarct size were divided into four groups below:large infarct size group;middle infarct size group;small infarct size group and lacunar infarction group.The CECs were detected by flow cytometry(FCM).The definition of CECs was CD146+CD45-cells according to literature.Peripheral blood after anticoagulant and antibody incubation,was cracking of red blood cells,buffer and centrifugal.After washing,blending then was tested by computer.Use flow cytometry instrument to detect the CECs percentage of white blood cells,combined with the results of routine blood during the same period,calculated the content of CECs.All results were analyzed by applying SPSS software(version 21.0).Results:1 Compared the levels of CECs in peripheral blood between the ACI group and the control group32 cases of the ACI group had tested the levels of CECs both on the 1th day and the 7th day ACI group,46 cases of the ACI group were tested the levels of CECs only on the 1th day,normal control group had 17 cases.1.1 Comparison of the levels of CECs in peripheral blood between the 1th day group of ACI and the control groupThe distributions of data were abnormal,then express as median.The CECs level in the first day of ACI group(1869,1604/mL)was higher than that of control group(519,2486/mL),but the difference was not statistically significant(Z=-1.812,P =0.070).There was no difference in data of the 1th day group of ACI with the controls group.1.2 Comparison the levels of CECs in peripheral blood between the 7th day group of ACI and the control groupThe distributions of data were abnormal,then express as median.The CECs level in the 7th day of ACI group(2832,1471/mL)was markedly higher then that of control(519,2486/mL),the difference was statistically significant.(Z=-2.941,P=0.030).2 The change of levels of CECs in peripheral blood from the 1th day of ACI to the 7th day of ACIThe distributions of date were abnormal,then express as median.The total number of cases was 32,the number of cases was 5 that the level of CECs of the 1th day was higher than that of the 7th day,the number of cases was 27 and the level of CECs of the 1th day was lower than that of the 7th day,there was no case that the level of CECs of the 1th day was be equal to that of the 7th day.Also,the level of CECs in the 7th day of ACI group(2832,1471/mL)was markedly higher than that of the 1th day of ACI group(1988,1303/mL),the difference was statistically significant.(Z=3.759,P=0.001)3 The relationship between the levels of CECs with the infarct size3.1 The relationship between the levels of CECs that on the first day of ACI and the infarct sizeThe distributions of date from large infarct size group and middle infarct size group were normal,expressed as x ±S.The distributions of data from small infarct size group,lacunar infarction group were abnormal,then express as median.The large infarct size group(1828±897/mL,n=15),and middle infarct size group(4273±1971/mL,n=5),Small infarct size group(1917,3014/mL,n=12),lacunar infarction group(1452,801/mL n=14),the difference was statistically significant(Z=9.316,P=0.025).The CECs level of middle infarct size group was markedly higher than large infarct size group and lacunar infarction group(P < 0.05).3.2 The relationship between the levels of CECs that on the 7th day of ACI with the infarct sizeThe distributions of date from large infarct size group were abnormal,then express as median.The distributions of date from small infarct size group,lacunar infarction group and middle infarct size group were normal,then expressed as x ±S.The large infarct size group(2948,1045/mL,n=11),middle infarct size group(5311±2459/mL,n=4),small infarct size group(2556±1667/mL,n=8)and lacunar infarction group(2184±819/mL,n=9),the difference was statistically significant(Z=10.712,P=0.013).The CECs level of middle infarct size group were markedly higher than that of large infarct size group and,small infarct size group and lacunar infarction group(P < 0.05).The CECs level of large infarct size group were markedly higher than that of lacunar infarction group(P < 0.05).Conclusions:1 The CECs levels in the peripheral blood of patients with acute cerebral infarction are higher than that of healthy people,and the CECs level in the peripheral blood was rised within 7 days of patients with acute cerebral infarction.2 The CECs levels in peripheral blood is different in different infarct size of patients with acute cerebral infarction,the CECs levels on the 7th day of large and medium-sized infarction were markedly higher than small infarct size and lacunar infarction. |
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