Department of Nephrology, Hannover Medical School, Hannover, Germany.
J Stroke Cerebrovasc Dis. 2012 Aug;21(6):452-8. doi: 10.1016/j.jstrokecerebrovasdis.2010.11.003.
Circulating endothelial cells (CECs) are a novel and valuable marker of endothelial damage in a variety of vascular disorders. There is limited information as to CEC counts and the time course of CECs in subtypes of stroke.
We studied 49 patients with stroke (18 with atherothrombotic infarction in the territory of the middle cerebral artery, 16 with cardioembolic stroke, and 15 with lacunar stroke). We also included 16 healthy controls and 64 disease controls. CECs were isolated and enumerated with lectin-augmented CD146-driven immunomagnetic isolation. Neurologic deficit was assessed with the European Stroke Scale (ESS) and the National Institutes of Health Stroke Scale (NIHSS). Recovery was assessed with the modified Rankin scale (mRS).
Healthy controls had low numbers of CECs (median, 8 cells/mL; mean, 9 cells/mL; range, 0-16 cells/mL; n = 16). Patients with stroke had markedly elevated numbers of CECs at presentation. Patients with atherothrombotic infarction had 32 cells per milliliter (mean, 42 cells/mL; range, 24-116 cells/mL; n = 18; P < .001 when compared to controls). Patients with lacunar stroke had 68 cells per milliliter (mean, 68 cells/mL; range, 8-144 cells/mL; n = 15; P < .001 when compared to controls). Patients with cardioembolic stroke had 46 cells per milliter (mean, 54 cells/mL; range, 24-116 cells/mL; n = 16; P < .001 when compared to healthy controls). There was a tendency towards higher numbers of CECs in lacunar stroke. The number of CECs peaked at day 7 in patients with atherothrombotic infarction and came back to normal at day 90. In contrast, CECs in patients with acute lacunar stroke and cardioembolic stroke decreased progressively until day 90.
CECs are markers of endothelial damage and/or repair in stroke. Differences during the course of disease are likely to reflect different pathophysiology.
循环内皮细胞（CECs）是多种血管疾病内皮损伤的新型有价值标志物。关于中风亚型中 CEC 计数和 CEC 时间过程的信息有限。
我们研究了 49 名中风患者（18 名大脑中动脉区域的动脉血栓形成性梗死，16 名心源性栓塞性中风，15 名腔隙性中风）。我们还纳入了 16 名健康对照者和 64 名疾病对照者。使用凝集素增强的 CD146 驱动免疫磁分离法分离并计数 CECs。用欧洲卒中量表（ESS）和美国国立卫生研究院卒中量表（NIHSS）评估神经功能缺损。用改良 Rankin 量表（mRS）评估恢复情况。
健康对照者 CEC 数量较少（中位数 8 个/mL；均值 9 个/mL；范围 0-16 个/mL；n=16）。中风患者发病时 CEC 数量明显升高。动脉血栓形成性梗死患者为 32 个/mL（均值 42 个/mL；范围 24-116 个/mL；n=18；与对照组相比 P<.001）。腔隙性中风患者为 68 个/mL（均值 68 个/mL；范围 8-144 个/mL；n=15；与对照组相比 P<.001）。心源性栓塞性中风患者为 46 个/mL（均值 54 个/mL；范围 24-116 个/mL；n=16；与健康对照组相比 P<.001）。腔隙性中风患者的 CEC 数量有升高趋势。动脉血栓形成性梗死患者的 CEC 数量在第 7 天达到峰值，第 90 天恢复正常。相比之下，急性腔隙性中风和心源性栓塞性中风患者的 CEC 数量逐渐减少，直到第 90 天。
CECs 是中风内皮损伤和/或修复的标志物。疾病过程中的差异可能反映了不同的病理生理学。
