抗中性粒细胞胞浆抗体相关血管炎患者循环内皮细胞的变化及其临床意义  

The changes and clinical significance of circulating endothelial cells of ANCA associated vasculitis patients

作　　者：姚根宏[1] 张国栋[2] 栾建凤[1] 朱培元[1] 叶东[1] 严京梅 雷千红[1] 

机构地区：[1]南京军区南京总医院输血科,210002 [2]南京医科大学临床学院

出　　处：《临床内科杂志》2009年第12期836-838,共3页Journal of Clinical Internal Medicine

基　　金：中国博士后基金（20060390940）和南京军区南京总医院科研基金（M 2008067）资助

摘　　要：目的动态监测抗中性粒细胞胞浆抗体相关血管炎（AAV）患者外周血内皮细胞（CEC），探讨其在肾脏血管病变的诊断和判断疗效中的作用。方法采用免疫磁珠分离法计数20例AAV患者和30例健康志愿者的外周血循环内皮细胞的数量，同时进行血清肌酐、尿蛋白、尿红细胞和血清白蛋白等临床项目的检查。结果AAV患者外周血循环内皮细胞数目明显高于对照组（P〈0．01）；部分经过治疗的AAV患者，随着病情的缓解，其外周血循环血内皮细胞明显降低。外周血循环内皮细胞数目降低与肌酐、24小时尿蛋白和尿红细胞的减少呈正相关，而与血清白蛋白升高呈负相关。结论检测循环内皮细胞的数量不仅能反映AAV患者血管病变的存在，而且还能作为判断血管病变治疗效果的指标。Objective To investigate the effects of circulating endothelial cells （CECs） on the diagnosis and treatment assessment of renal vascular injury in patients with ANCA （ antineutrophil cytoplasmic antibody） associated vasculitis（AAV）. Methods Twenty patients were diagnosed as AAV by renal biopsy and thirty age- and sex- matched healthy volunteers served as controls. CECs were isolated from peripheral blood with anti-CD-146-coated immunomagnetic dynabeads and were counted by microscopy. The serum creatinine （Scr） ,24 h urine protein （24 h Upro）, urine erythroeyte （URBC） and serum albumin were also measured. Result The CECs were significantly higher in patients with AAV than those of control （47.6 ± 7.8 vsl4.7 ± 2.0 cells/ml, P 〈 0.01 ）. The number of CECs significantly decreased in some remission patients after MMF treatment. There were significant positive correlations between CECs and Scr,24 h Upro, or URBC. There was significant negative correlation between CECs and serum albumin. Conclusions Circulating endothelial ceils are novel biomarkers of vascular injury of renal diseases. Dynamic observation of the numbers of CECs can provide evidence to diagnose and assess the effect of the therapy.

关 键 词：抗中性粒细胞胞浆抗体相关血管炎 血管病变 循环内皮细胞 

分 类 号：R54[医药卫生—心血管疾病] R59[医药卫生—内科学]