冠状动脉严重狭窄SAP患者的侧支循环、EPCs、SDF-1α变化及意义  

Changes and significance of collateral circulation,EPCs,SDF-1α in SAP patients with serious coronary artery stenosis

作　　者：祁学文[1] 刘海峰[1] 杨传胜[1] 

机构地区：[1]聊城市人民医院,山东聊城252000

出　　处：《山东医药》2011年第43期28-30,共3页Shandong Medical Journal

基　　金：聊城市科技局资助项目(200632905)

摘　　要：目的探讨冠状动脉严重狭窄稳定型心绞痛(SAP)患者循环内皮祖细胞(EPCs)及基质细胞衍生因子(SDF)-1α与冠状动脉侧支循环(CCC)形成的关系,为冠心病的治疗提供新思路。方法研究对象为同期收治的92例冠状动脉严重狭窄的SAP患者(CCC良好42例、不良50例),均采集外周血测定EPC数量、体外生成血管能力,并用ELISA法检测其血浆SDF-1α水平,采用直线相关和Pearson检验分析CCC良好与不良者各指标间及与CCC分级的相关性;同上分离92例患者外周血单个核细胞并随机分为6组,分别加入含有PBS、SDF-1α(10 5、0、100 ng/ml)、SDF-1α(100 ng/ml)+CXCR4拮抗剂AMD3100、SDF-1α(100 ng/ml)+血管内皮生长因子(VEGF)特异性受体酪氨酸激酶抑制剂KI8751的培养液,培养至第7天同上测定EPCs数量、体外生成血管能力,采用ELISA法检测培养液中VEGF水平。结果与CCC不良者比较,CCC良好者EPCs集落形成数量增加、体外生成血管能力增强,且血浆SDF-1α水平增加,三指标间及与CCC分级均呈显著正相关(P均<0.01);与PBS及SDF-1α+AMD3100、SDF-1α+KI8751干预者比较,SDF-1α可呈剂量依赖性显著上调EPCs数量、增强其体外生成血管能力及VEGF水平(P<0.05、0.01)。结论冠状动脉严重狭窄的SAP患者CCC形成情况与循环EPCs及血浆SDF-1α水平有关,VEGF可能参与此过程的调节;提高VEGF及SDF-1α活性可能对冠心病患者有益。Objective To investigate the relationship between coronary collateral circulation （CCC） and endothelial progenitor cells （EPCs） , stromal cell derived factor-1α （SDF-1α） in stable angina pectoris （SAP） patients with serious coronary stenosis, and to provide new thread to coronary artery disease. Methods The subjects were 92 SAP patients with serious coronary artery stenosis, in which 42 patients with well CCC and 50 patients with poor CCC. EPCs were isolated from peripheral blood samples, then its colonies were counted and vasculargenesis capacity in vitro was assayed respectively. The plasma level of SDF-1α was determined by enzyme linked immunosorbent assay. Rectilinear correlation and Pearson analysis were adopted to analyze the correlation of above indexes and CCC classification. MNC were isolated from peripheral blood samples of 92 patients, then were divided into 6 groups with addition of PBS, SDF-1α （with final concentrations of 10,50,100 ng/ml）, SDF-lct（100 ng/ml） ＋ AMD3100（20 ng/ml）, SDF-1α（ 100 ng/ml） ＋ KI8751 （20 ng/ml） respectively. EPC colonies were counted and vasculargenesis capacity were assayed respectively, and vascular endothelial growth factors from the culture medium were also measured by ELISA after 7 days. Results CCC well group exhibited an increased number of colony-forming units （CFUs）, vasculargenesis in vitro and level of SDF-1α, compared with CCC poor group. There was a positive correlation between the 3 indexes and the classification of CCC （ all P 〈 0.01 ）. Compared with groups of PBS, SDF-1α＋ AMD3100, SDF-1α＋ K8751, the number of CFUs and vasculargenesis capacity in vitro of cultured EPCs, concentration of VEGF in the culture medium were increased with a dose-dependent manner by SDF-1α（ P 〈 0.05,0. 01 ）. Conclusions The development of CCC in SAP patients with serious coronary artery stenosis is correlated with EPCs and the level of SDF-1α, and this procedure maybe regulated by VEGF. The method improving the activ

关 键 词：冠状动脉粥样硬化性心脏病 内皮祖细胞 基质细胞衍生因子-1Α 侧支循环 

分 类 号：R541.4[医药卫生—心血管疾病]