冠心病患者循环内皮祖细胞与尿酸检测及相关性

The Relationship between Uric Acid and Circulating Endothelial Progenitor Cell in Patients with Coronary Artery Disease and Its Clinical Significance

目的探讨冠心病患者循环内皮祖细胞与尿酸的关系及临床意义。方法42例冠心病患者均经选择性冠状动脉造影证实有明显的冠状动脉狭窄;36例对照组经临床检查和选择性冠状动脉造影排除冠心病。测定各组患者血清尿酸水平;采集研究对象外周血进行内皮祖细胞的分离培养,14天后倒置相差显微镜下计数细胞克隆形成单位评估循环内皮祖细胞水平。结果冠心病组血清尿酸水平明显高于对照组(P<0.01),单支与多支冠状动脉病变组尿酸水平差异无显著性(P>0.05)。冠心病组中稳定型心绞痛组及急性冠状动脉综合征组循环内皮祖细胞水平均明显低于对照组(P<0.01);单支、双支、三支冠状动脉病变组内皮祖细胞水平均显著低于对照组(P<0.01)。血清尿酸与循环内皮祖细胞水平呈负相关(r=-0.382,P=0.037)。结论冠心病患者血清尿酸水平与循环内皮祖细胞水平呈负相关,血清尿酸可能通过抑制内皮祖细胞数量从而减弱内皮祖细胞参与损伤内皮修复的能力,与冠心病发生及临床表现相关。

Aim To investigate the correlation between uric acid and circulating endothelial progenitor cell （ EPC ） in patients with coronary artery disease （CAD）and its clinical significance. Methods 78 cases were divided into 3 groups： stable angina pectoris （SAP）group（ n = 18）, acute coronary syndrome （ACS）group（ n= 24）and control group （ n = 36）, and CAD patients were divided into 3 groups according to the result of coronary angiography： single vessel disease group（ n = 18）, double vessels disease group （ n =14）and triple vessels disease group（ n= 10）. The concentration of serum uric acid was measured with method of uric acid enzyme. Total mononuclear cell were isolated from peripheral blood by Ficoll density gradient centrihtgation, and were cultured in M199 medium supplemented with 20% fetal bovine serum , 50μg/L vascular endothelial growth factor （VEGF）. After 14 days cultured, the number of colony-forming units of EPC were counted by phase-contrast microscope. Results The uric acid level in the CAD group was significantly higher than those in control group （ P〈0.01 ）, and there was no statistical difference between the uric acid level of single vessel disease group and that of multiple vessels disease groups （P〉0.05）. The number of colony-forming units of circulating EPC in CAD group （including SAP and ACS groups）was significantly lower than those in control group （ P〈0.01 ）, and the circulating EPC level of single, double, triple vessels disease group were significantly lower than that of control group （ P〈0.01 ）. It was also observed there was a strong negative correlation between the concentration of serum uric acid and the number of colony-forming units of circulating EPC （ r = - 0. 382, P = 0. 037 ）. Conclusions The serum uric acid concentration in CAD group was higher than that of control group, but the levels of uric acid were independent of the degree of coronary artery disease. The levels of circulating EPC of CAD patients were lower than those of healthy person. Uric acid and EPC were associated with CAD and the severity of coronary artery lesion, and the level of uric acid was negatively correlated with the number of colony-forming units of circulating EPC. These data indicate that uric acid may impair EPC-mediated reendothelialization after endothelial cell injury by inhibiting the number of the EPC, and uric acid and EPC are correlated with the degree of patient＇s condition and the clinical situation of cardiovascular disease.