内皮祖细胞与雌激素联合应用防止PCI术后再狭窄的研究  

Endothelial progenitor cells in combination with estrogen against restenosis after percutaneous coronary intervention

作　　者：徐付彪[1] 李继福[1] 户克庆[1] 邵娜[1] 刘春喜[2] 杨智[2] 

机构地区：[1]山东大学齐鲁医院心内科 [2]教育部与卫生部心血管功能与重构重点实验室,济南250012

出　　处：《山东大学学报（医学版）》2009年第10期39-44,49,共7页Journal of Shandong University:Health Sciences

基　　金：山东省科技厅资助课题(Y2006)

摘　　要：目的探讨内皮祖细胞(EPC)与雌激素联合应用防止PCI术后再狭窄的效果。方法雌性新西兰大白兔60只随机分为5组,每组12只。Ⅰ:假手术组;Ⅱ:对照组;Ⅲ:雌激素组;Ⅳ:EPC组;Ⅴ:雌激素+EPC组。卵巢切除术后,Ⅲ组和Ⅴ组给予雌激素替代治疗,其余动物皮下注射生理盐水,卵巢切除前及卵巢切除后3d、2周分别采血,应用放免法检测血清雌激素水平。实验动物高脂饮食6周后应用氧化酶法检测血浆总胆固醇、甘油三酯水平;用直接法检测低密度脂蛋白胆固醇及高密度脂蛋白胆固醇。从兔外周血分离培养单个核细胞,制备EPC悬液以备细胞移植。建立兔腹主动脉损伤模型,Ⅰ组动物仅分离暴露出股动脉而不做球囊损伤,Ⅳ组和Ⅴ组动物损伤血管局部经导管给予EPC悬液2mL输注,其余动物(除Ⅰ组外)给予生理盐水2mL,4周后,伊文斯蓝染色检测损伤血管段内皮修复程度,免疫组化法检测细胞增殖程度,HE染色观察管腔丢失情况。结果与Ⅰ、Ⅱ、Ⅳ组相比,Ⅲ、Ⅴ组雌激素水平明显升高(P<0.01),总胆固醇、低密度脂蛋白胆固醇明显降低(P<0.01),高密度脂蛋白胆固醇明显升高(P<0.15),甘油三脂差异无统计学意义(P>0.05)。Ⅴ组与Ⅲ、Ⅳ组相比,内皮修复程度、细胞增殖程度及管腔丢失程度差异有统计学意义,分别为[(90.2±5.1)%vs(85.1±4.1)%、(83.9±6.5)%,P<0.05],[(15.67±2.98)%vs(26.02±4.18)%、(24.87±3.54)%,P<0.01],[(17.61±2.69)%vs(38.43±4.35)%、(41.15±4.45)%,P<0.01]。结论EPC与雌激素联合应用能加速内皮修复,减少血管腔丢失。Objective To investigate the effect endothelial progenitor cells（EPC）in combination with estrogen on restenosis after percutaneous coronary intervention.Methods Sixty New Zealand white rabbits were randomly divided into five groups：the sham operation group（group-Ⅰ）,the control group（group-Ⅱ）,the estrogen treated group（group-Ⅲ）,the EPC treated group（group-Ⅳ）,and the estrogen in combination with EPC group（group-Ⅴ）,with twelve rabbits in each group.Three days after ovariectomy,animals in groups Ⅲ and Ⅴ were treated with estrogen,and the others were given physiological saline.The level of estrogen was detected before ovariectomy,and on day 3 and 2 weeks after ovariectomy.Levels of blood lipids（including total cholesterol,triglyceride,high density lipoprotein choesterol and low density lipoprotein cholesterol）were also detected after hyperlipemia feeding for 6 weeks.Mononuclear cells were isolated from the peripheral blood of rabbits and cultured for implantation.Afterestablishing animal models of injured abdominal aorta,animals in the sham-operation group had the femoral artery exposed without injuries.At the same time,rabbits in groups Ⅳ and Ⅴwere subjected to suspension of EPC at 2ml through a catheter and the others（except Ⅰ group）were given physiologicalsaline. Endothelium recovery, degree of cell proliferation and lumen loss were evaluated after 4 weeks. Results The level of estrogen in groups Ⅲ and Ⅴwere obviously higher than that in groups Ⅰ , Ⅱand Ⅳ（ P 〈 0.01 ）. The levels of blood lipids, including total cholesterol （ P 〈 0.01 ）, low density lipoprotein cholesterol （ P 〈 0.01 ）and high density lipoprotein choesterol（ P 〈 0.05）were statistically different between groups Ⅱ Ⅳ.and groups Ⅰ , Ⅱ Ⅳ. There were also a statistical significance in the degree of endothelium recovery, cell proliferation and lumen loss between group V and groups m, IV[（90.2±5.1）% vs （85.1±4.1）% and （83.9±6.5）%,P〈0.05], [�

关 键 词：内皮祖细胞 雌激素 再狭窄 内皮化 新生内膜增生 兔 

分 类 号：R543[医药卫生—心血管疾病] R-332[医药卫生—内科学]