冠状动脉严重狭窄的稳定型心绞痛患者侧支循环与内皮祖细胞的关系研究  

The relationships of collateral formation in patients with serious coronary artery disease and endothelial progenitor cells

作　　者：祁学文[1] 刘海峰[2] 马龙乐[1] 王孟赞[1] 

机构地区：[1]泰山医学院聊城临床学院心内科,山东省聊城252000 [2]泰山医学院聊城临床学院保健科

出　　处：《中国医师杂志》2011年第9期1177-1180,共4页Journal of Chinese Physician

基　　金：山东省聊城市科技攻关项目（200632905）

摘　　要：目的探讨冠状动脉严重狭窄的稳定型心绞痛患者冠状动脉侧支循环形成与循环内皮祖细胞（EPCs）的关系。方法将2008年12月至2010年3月期间入院的稳定性心绞痛患者，经冠状动脉造影检查冠脉有重度狭窄的，将其分为侧支循环良好组（Coil＋组，／7,=42）和侧支循环不良组（Coll一组，n=50）。采集研究对象外周血40m1进行EPCs的分离培养，计数EPCs的数量，测定其体外成血管能力，并用酶联免疫吸附法检测92例入选者血浆SDF－1d水平。结果Coll＋组EPCs数量显著高于Coll一组[（22．10±4．69）CFUs／10。EPCsVS（16．90±3．66）CFUs／10。EPCs，P〈0．01]，其体外成血管能力也明显强于Coil一组（25．3±3．2Vfi17．4±2．6，P〈0．01），血浆SDF—1a水平显著高于Coll一组[（243．7±19．2）ng／mlvs（203．1±17．8）ng／ml，P〈0．01]。EPCs的数量、体外成血管能力、血浆SDF－1d水平与侧支循环程度呈正相关（r=0．74，0．69，0．82，P〈0．01），同时EPCs的数量、体外成血管能力与血浆SDF－10【水平呈正相关（r=0．81，0．64，P〈0．01）。结论冠脉严重狭窄的冠心病患者其冠脉侧支良好者循环内皮祖细胞数量增多、体外成血管能力增强，这种变化可能与血浆SDF－1“水平升高有关，提高内皮祖细胞的数量、功能以及SDF－1仅活性的治疗方法将对冠心病患者有益。Objective To explore the effect of endothelial progenitor cells （EPCs） on the development of collateral formation in stable angina patients with serious coronary artery disease. Methods The subjects were patients （ n = 92） who underwent coronary angiography （CAG） and had chronic total occlusion （CTO） in one major coronary artery. They were divided into two groups, patients without collaterals （ coll-, n = 50） and patients with collaterals （ coil ＋ , n = 42 ）. EPCs were isolated from peripheral blood samples and cultured. The numbers of colony-forming units （CFUs） and the vasculargenesis capacity in vitro was assayed respectively. The plasma level of SDF-1a was determined by enzyme linked immunosorbent assay. Results The number of colony-forming units （ CFUs ） [ （ 22. 10 ±4. 69 ） CFUs/106 EPCs vs （16. 90 ±3.66）CFUs/lO6 EPCs], vasculogenesis capacity in vitro （25.3 ±3.2 vs 17. 4 ±2. 6） and plasma level of SDF-1a[ （243.7± 19.2） ng/ml vs （203.1 ± 17.8） ng/ml, P 〈0. 01 ] in coll＋ group were higher than that of coil group. It had a positive correlation between the level of collateral circulation and the numbers of CFUs, vascular genesis activity of circulating EPCs and plasma level of SDF-loL（ r = 0. 74, 0. 69,0. 82,0. 81,0. 64, P 〈 0. 01 ）. Conclusions The number of CFUs and vasculargenesis activity of EPC in coll＋ group with serious coronary artery disease is significantly higher than that in coll- group. These changes may be related to the increase of plasma SDF-1a. The method improving the numbers and function of EPCs, increasing the activity of SDF-1a may benefit the patients with coronary artery disease.

关 键 词：冠状动脉狭窄/并发症 心绞痛/并发症/病理学 侧支循环 内皮细胞 

分 类 号：R541.4[医药卫生—心血管疾病]