血内皮祖细胞与降钙素基因相关肽在慢性阻塞性肺疾病并发肺动脉高压中的变化及意义  

Changes of endothelial progenitor cells and calcitonin gene-related peptide in patients with pulmonary arterial hypertension secondary to chronic obstructive pulmonary disease

作　　者：孙立红[1] 肖海云[2] 刘海峰[1] 杨海涛[1] 葛婷婷[1] 

机构地区：[1]聊城市人民医院呼吸内科,252000 [2]山东省肿瘤医院内科,聊城252000

出　　处：《国际呼吸杂志》2010年第9期513-517,共5页International Journal of Respiration

摘　　要：目的观察慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）并发肺动脉高压（pulmonary arterial hypertension，PAH）患者外周血内皮祖细胞（endothelial progenitor cells，EPC）数量和功能及降钙素基因相关肽（calcitonin gene-related peptide，CGRP）的变化，并探讨其在COPD并PAH发病中的作用。方法选择聊城市人民医院住院的COPD患者60例，其中COPD并PAH（COPD＋PAH组）患者30例，COPD非PAH患者30例（COPD组）；正常对照20名（非COPD组）、用密度梯度离心法从外周血获取单个核细胞，将其接种在人纤维连接蛋白包被培养板，培养7d后对贴壁细胞进行细胞化学分析。通过集落形成试验、改良的Boyden小室和黏附能力测定实验计数EPC的数量、测定EPC的迁移和黏附能力。用放射免疫法检测入选患者血浆CGRP水平。结果与正常对照组及COPD组相比，COPD＋PAH组外周血EPC数量明显减少，黏附和迁移能力显著降低（F=9．52～14．35，q=3．36～8．12，P〈0．05），且EPC数量及黏附、迁移能力与肺动脉压力呈负相关（r=-0．73、-0．79、-0．81，P〈0．01）。COPD＋PAH组患者血浆CGRP水平明显低于对照组（P〈0．01）．CGRP浓度与循环EPC数量及迁移能力呈正相关（r=0．71，0．73），与循环血EPC黏附能力无相关性。结论COPD患者PAH的发生可能与循环EPC数量减少、迁移和黏附能力降低有关，这种变化可能与血浆CGRP水平减少有关。Objective To investigate the changing of number and function of endothelial progenitor cells （EPC）and calcitonin gene-related peptide （CGRP）in patients with pulmonary arterial hypertension （PAH） secondary to chronic obstructive pulmonary disease （COPD）. Methods Mononuclear cells from 20 healthy persons （the control group, n = 20）, COPD patients without PAH （COPD non-PAH group, n = 30） and patients with PAH secondary to COPD（COPD and PAH group, n =30） were investigated. Total mononuclear cells were isolated from peripheral blood by Ficoll density gradient centrifugation. EPC number and migration were assayed by colony forming unit EPC（CFU-EPC）assay and modified Boyden chamber assay, respectively. EPC adhesion assay was performed by replating those on fihronectin-coated dishes, then adherent cells were counted. The concentration of CGRP was measured using radioimmunoassay. Results The number of CFU and migration,adhesion activity of circulating EPC in COPD and PAH group is significantly lower than that in non COPD group and COPD non-PAH group. It was also observed that a strong negative correlation between the level of PAH and the number of CFU and adhesion,migration activity of circulating EPC. The CGRP level in the PAH groups was significantly lower than that in control group（ P 〈0.01）. The CGRP level was positively correlated with number and migration ability of EPC （ r =0.71,0.73）, and not correlated with adhesion ability. Conclusions The number of CFU and migratory, adhesive activity of EPC in patients with PAH secondary to COPD issignificantly decreased. These change can be associated with low level of plasma CGRP.

关 键 词：肺疾病 阻塞性 高血压 肺性 内皮祖细胞 降钙素基因相关肽 

分 类 号：R563.9[医药卫生—呼吸系统] R543[医药卫生—内科学]