van Ierssel Sabrina H, Conraads Viviane M, Van Craenenbroeck Emeline M, Liu Yin, Maas Andrew I R, Parizel Paul M, Hoymans Vicky Y, Vrints Christiaan J, Jorens Philippe G
Department of Critical Care Medicine, Antwerp University Hospital, University of Antwerp, Edegem, Belgium; Department of Internal Medicine, Antwerp University Hospital, University of Antwerp, Edegem, Belgium.
J Neurosci Res. 2015 Jun;93(6):866-72. doi: 10.1002/jnr.23566. Epub 2015 Feb 9.
Cerebral ischemia (CeI) is a major complicating event after acute brain injury (ABI) in which endothelial dysfunction is a key player. This study evaluates cellular markers of endothelial function and in vivo reactive hyperemia in patients with ABI and their relationship to the development of cerebral ischemia. We studied cellular markers of endothelial dysfunction and the peripheral reactive hyperemia index (RHI) in 26 patients with ABI at admission and after 6 and 12 days, and compared these with those of healthy volunteers (n = 15). CeI was determined clinically or by computer tomography. In patients with ABI, RHI at admission was significantly reduced compared with healthy subjects (P = 0.003), coinciding with a decrease in circulating endothelial progenitor cells (EPC; P = 0.002). The RHI recovered in eight patients without development of CeI, but failed to fully recover by day 12 in three of four patients who developed CeI. Despite recovery of the RHI within 12 days in these patients (P = 0.003), EPC count remained significantly lower after 12 days in patients with ABI (P = 0.022). CD31(+) T cells and endothelial microparticles were not different between controls and patients. No differences were noted in cellular markers of endothelial dysfunction in patients developing CeI and those not. In conclusion, patients with ABI exhibit impaired microvascular endothelial function measured as RHI and a decreased circulating level of EPC.
脑缺血（CeI）是急性脑损伤（ABI）后的主要并发症，其中内皮功能障碍起关键作用。本研究评估了ABI患者内皮功能的细胞标志物和体内反应性充血情况，以及它们与脑缺血发生发展的关系。我们在入院时、6天和12天后研究了26例ABI患者内皮功能障碍的细胞标志物和外周反应性充血指数（RHI），并将其与15名健康志愿者的相关指标进行比较。通过临床或计算机断层扫描确定是否发生CeI。在ABI患者中，入院时的RHI与健康受试者相比显著降低（P = 0.003），同时循环内皮祖细胞（EPC）数量减少（P = 0.002）。8例未发生CeI的患者RHI恢复，但4例发生CeI的患者中有3例在第12天时未完全恢复。尽管这些患者在12天内RHI恢复（P = 0.003），但ABI患者在12天后EPC计数仍显著较低（P = 0.022）。对照组和患者之间CD31(+) T细胞和内皮微粒无差异。发生CeI的患者和未发生CeI的患者在内皮功能障碍的细胞标志物方面无差异。总之，ABI患者表现出以RHI衡量的微血管内皮功能受损以及循环EPC水平降低。
