COPD并发肺动脉高压病人外周血内皮祖细胞数量和功能的变化

CHANGES OF ENDOTHELIAL PROGENITOR CELLS IN PATIENTS WITH PULMONARY HYPERTENSIVE ARTERIAL DISEASE SECONDARY TO CHRONIC OBSTRUCTIVE PULMONARY

目的观察慢性阻塞性肺疾病(COPD)并发肺动脉高压(PAH)病人外周血内皮祖细胞(EPC)数量和功能的改变,探讨其在COPD并PAH发病中的作用。方法选择非COPD非PAH(非COPD组)病人15例、COPD非PAH(COPD组)病人15例、COPD并PAH(COPD+PAH组)病人30例,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上,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。结果与非COPD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,差异有显著性(F=9.79～15.42,q=3.578～7.963,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=-0.87、-0.89、-0.93,P<0.01)。结论COPD病人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,EPC数量和功能可作为评价COPD并PAH病人预后的一项指标。

Objective To investigate the changing of number and function of endothelial progenitor cells （EPC） in patients with pulmonary hypertensive arterial （PHA） secondary to chronic obstructive pulmonary disease （COPD）. Methods Mononuclear cells from non-COPD without PAH patients （non-COPD group, n=15）, COPD patients without PAH （COPD nonPAH group, n=15） 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 measured by colony forming unit -EPCs （CFU-EPCs） assay and modified Boyden chamber assay, respectively. EPC adhesion assay was performed by replating those on fibronectin-coated dishes, then adherent cells were counted. Results The number of CFU and migration, adhesion activity of circulating EPCs in COPD and PAH group was significantly lower than that in non-COPD group and COPD non PAH group. There was significant negative correlation between the level of PAH and the number of CFU, and adhesion and migration activity of circulating EPCs. Conclusion The number of CFU and migratory, adhesive activity of EPC in patients with PAH secondary to COPD is significantly decreased.