Sobrino Tomás, Rodríguez-González Raquel, Blanco Miguel, Brea David, Pérez-Mato María, Rodríguez-Yáñez Manuel, Leira Rogelio, Castillo José
Clinical Neuroscience Research Laboratory, Department of Neurology, Hospital Clínico Universitario, IDIS, University of Santiago de Compostela, Spain.
Neurol Res. 2011 Jul;33(6):572-7. doi: 10.1179/016164110X12807570510176.
The increase in circulating endothelial progenitor cells (EPCs) is associated with a better outcome in patients with acute ischemic stroke. CDP-choline (citicoline) increases brain plasticity after experimental stroke. Therefore, we study if citicoline treatment could increase the EPC concentration after ischemic stroke.
Forty-eight patients with a first-ever non-lacunar ischemic stroke were consecutively included in the study within 12 hours of symptoms onset. Patients received treatment (n = 26) or non-treatment (n = 22) with oral citicoline (2000 mg/day) from acute phase of ischemic stroke and for 6 weeks. EPC colonies were quantified as early outgrowth colony forming unit-endothelial cell (CFU-EC) at admission (before citicoline treatment) and day 7. We defined the EPC increment during the first week as the difference in the numbers of CFU-EC between day 7 and admission.
CFU-ECs were similar at baseline between patients treated and non-treated with citicoline (7.7±6.1 versus 9.1±7.3 CFU-EC, P = 0.819). However, patients treated with citicoline and recombinant tissue-plasminogen activator (rt-PA) showed a higher EPC increment compared to patients treated only with citicoline or non-treated (35.4±15.9 versus 8.4 ± 8.1 versus 0.9 ± 10.2 CFU-EC, P < 0.0001). In a logistic model, citicoline treatment [odds ratio (OR), 17.6; confidence interval (CI) 95%, 2.3-137.5, P = 0.006] and co-treatment with citicoline and rt-PA (OR, 108.5; CI 95%, 2.9-1094.2, P = 0.001) were independently associated with an EPC increment⩾4 CFU-EC.
The administration of citicoline and the co-administration of citicoline and rt-PA increase EPC concentration in acute ischemic stroke.
循环内皮祖细胞（EPCs）数量增加与急性缺血性脑卒中患者更好的预后相关。胞磷胆碱（西地那非）可增加实验性脑卒中后的脑可塑性。因此，我们研究西地那非治疗是否能增加缺血性脑卒中后的EPC浓度。
48例首次发生非腔隙性缺血性脑卒中的患者在症状发作后12小时内连续纳入本研究。患者从缺血性脑卒中急性期开始接受口服胞磷胆碱（2000mg/天）治疗或不治疗（n = 22），持续6周。在入院时（胞磷胆碱治疗前）和第7天，将EPC集落定量为早期生长集落形成单位 - 内皮细胞（CFU - EC）。我们将第一周内EPC的增加定义为第7天和入院时CFU - EC数量的差异。
接受胞磷胆碱治疗和未接受治疗的患者在基线时CFU - EC相似（7.7±6.1对9.1±7.3 CFU - EC，P = 0.819）。然而，与仅接受胞磷胆碱治疗或未治疗的患者相比，接受胞磷胆碱和重组组织型纤溶酶原激活剂（rt - PA）治疗的患者EPC增加更高（35.4±15.9对8.4±8.1对0.9±10.2 CFU - EC，P < 0.0001）。在逻辑模型中，胞磷胆碱治疗[比值比（OR），17.6；95%置信区间（CI），2.3 - 137.5，P = 0.006]以及胞磷胆碱与rt - PA联合治疗（OR，108.5；CI 95%，2.9 - 1094.2，P = 0.001）与EPC增加⩾4 CFU - EC独立相关。
胞磷胆碱的给药以及胞磷胆碱与rt - PA的联合给药可增加急性缺血性脑卒中患者的EPC浓度。
