自体血管内皮祖细胞移植治疗高肺血流量肺动脉高压  

Transplantation of autologous endothelial progenitor cells to treat high blood flow-induced pulmonary artery hypertension

作　　者：吕民[1] 陈丽波[2] 赵冬梅[1] 

机构地区：[1]吉林大学中日联谊医院心血管外科,长春130033 [2]吉林大学中日联谊医院超声科,长春130033

出　　处：《中华实验外科杂志》2015年第2期370-373,共4页Chinese Journal of Experimental Surgery

基　　金：吉林省产业技术研究与开发项目（2013C028-5）;吉林省科技发展计划资助项目（20130413007GH）

摘　　要：目的 观察自体血管内皮祖细胞（EPCs）移植对高肺血流肺动脉高压（PAH）的治疗作用.方法 将30头实验幼猪随机分为3组,每组10头.假手术组（Sham组）仅开胸;对照组（Control组）行左胸后外侧切口,降主动脉与主肺动脉分流术;EPCs治疗组（EPCs组）手术操作同对照组,术后2周给予EPCs 2＆#215;10 7个细胞,颈静脉输入.术前与术后30 d,观察3组猪的肺动脉收缩压（PASP）、肺血管阻力（PVR）,血清基质金属蛋白酶（MMP）-9、内皮素-1（ET-1）、白细胞介素（IL）-6、IL-8水平变化,以及肺组织p38丝裂原激活蛋白激酶（p38 MAPK）表达活性,肺动脉标本的组织学变化.结果 术后30 d,与Sham组比较,PASP、PVR、MMP-9、ET-1、IL-6、IL-8、p38MAPK在Control组[（6.63±1.20） kPa、（10.44 ±2.53） wood＇s U、（76.63±10.39） μg/L、（103.66±17.31） μg/L、（43.00 ±7.33） ng/L、（67.39±9.65） ng/L、3.63 ±0.33]和EPCs组[（4.07 ±0.77） kPa、（6.27±0.65） wood＇s U、（64.11 ±9.73） μg/L、（90.44±13.11） μg/L、（30.44±8.17） ng/L、（53.23±7.37） ng/L、1.73 ±0.37]明显升高（P＜0.01）;EPCs组明显低于Control组（P＜0.05）;肺组织病理学改变,Control组最为明显,EPCs组轻度改变,Sham组未见明显病理改变.结论 EPCs移植对高肺血流肺动脉高压具有治疗作用,其机制可能为抑制MMP-9、ET-1等致肺组织重构因素的水平,以及抑制肺动脉高压过程中的炎症损伤而发挥作用.Objective To stidy the effects of the transplantation of autologous endothelial progenitor cells （EPCs） on high blood flow-induced pulmonary artery hypertension （PAH）.Methods Thirty piglets were divided into three groups randomly.The animals in sham group （n =10） underwent thoracotomy only,those in control group （n =10） were subjected to the descending aorta and the main pulmonary artery shunt via left posterolateral thoracotomy,and those in EPCs ＋ shunt group （n =10） were given EPCs （2 ＆#215; 107） intravenously after descending aorta and the main pulmonary artery shunt procedure for two weeks.All animals are normally raised for one month.Then their pulmonary artery systolic pressure （PASP） and pulmonary vascular resistance （PVR） were measured,the levels of serum matrix metalloproteinase （MMP）-9,endothelin （ET）-1,interleukin （IL）-6,and IL-8 were tested,p38 mitogen-activated protein kinase （p38MAPK） activity in the lung tissue was detected,and pulmonary artery structures were observed.Results As compared with the Sham group,the levels of PASP,PVR,MMP-9,ET-1,IL-6 and IL-8,and activity of p38MAPK were significantly increased in control group [（6.63 ± 1.20） kPa,（10.44±2.53） wood＇s U,（76.63±10.39） μg/L,（103.66±17.31） μg/L,（43.00± 7.33） ng/L,（67.39 ±9.65） ng/L,3.63 ±0.33] and EPCs ＋ shunt group [（4.07 ±0.77） kPa,（6.27 ± 0.65） wood＇ s U,（64.11 ± 9.73） μg/L,（90.44 ± 13.11） μg/L,（30.44 ± 8.17） ng/L,（53.23 ± 7.37） ng/L,1.73 ± 0.37] （P 〈 0.01）,30 days postoperatively.These values were remarkablely decreased in EPCs ＋ shunt group as compared with those in control group （P 〈 0.05）.There were most obvious lung histologic changes in control group,mild changes in EPCs ＋ shunt group,and no obvious pathological changes in Sham group.Conclusion Transplantation of autologous EPCs attenuates dynamic pulmonary hypertension,which may be associated with the decreased levels of MMP-9 and ET-1 which c

关 键 词：高肺血流肺动脉高压 幼猪模型 血管内皮祖细胞 

分 类 号：R544.1[医药卫生—心血管疾病]