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目的探讨重型颅脑外伤后,外周血中内皮祖细胞(endothelial progenitor cells,EPCs)的变化及与预后的关系。方法选择2013年8月至2014年1月重庆市巴南区人民医院神经外科收治的10例重型颅脑损伤并行常规保守治疗且受伤时无肢体损伤(目的是为排除其他损伤导致的外周血EPCs变化)的患者作为病例组,其中男性为7例,女性为3例,年龄19~62(40.8±15.0)岁。选择同期10例健康者作为对照,年龄29~66(38.4±11.4)岁。分别在患者入院后1、4、7、14 d收集其外周血,通过流式细胞术检测其EPCs的百分率,分析EPCs的变化规律及与GCS评分改善的关系。结果与对照组相比,重型颅脑损伤循环EPCs含量从第1~4天逐渐降低,从第4~7天逐渐升高,第14天逐渐恢复至正常水平(P<0.05,P<0.01)。重型颅脑外伤患者外周血的EPCs含量分别在第7天(r=0.57,P<0.05)和第14天与GCS评分差呈正相关性(r=0.68,P<0.05)。结论重型颅脑损伤后循环血中EPCs的含量与预后有关。
Objective To investigate the relationship between the changes of endothelial progenitor cells (EPCs) and prognosis in patients with severe traumatic brain injury. Methods From August 2013 to January 2014, 10 patients with severe craniocerebral injury admitted in the Department of Neurosurgery, Banan District People’s Hospital of Chongqing were treated with routine conservative treatment without injury of limbs (the purpose was to exclude the peripheral blood EPCs caused by other injuries Change) of patients as a case group, including 7 males and 3 females, aged 19 to 62 (40.8 ± 15.0) years. Ten healthy controls were selected as controls, aged 29-66 (38.4 ± 11.4) years. Peripheral blood was collected at 1, 4, 7 and 14 days after admission. The percentage of EPCs was detected by flow cytometry. The changes of EPCs and the relationship with GCS score were analyzed. Results Compared with the control group, the circulating EPCs in severe traumatic brain injury gradually decreased from day 1 to day 4, gradually increased from day 4 to day 7, and returned to normal levels on day 14 (P <0.05, P <0.01) . The EPCs contents in the peripheral blood of patients with severe traumatic brain injury were positively correlated with the GCS score (r = 0.68, P <0.05) on the 7th day (r = 0.57, P <0.05) and 14th day respectively. Conclusion The contents of EPCs in the circulating blood after severe craniocerebral injury are related to the prognosis.