血管内皮祖细胞与内皮细胞生长因子在冠状动脉粥样硬化性心脏病状态时的变化

Changes of endothelial progenitor cells and vascular endothelial growth factor in patients with coronary artery disease

目的:观察冠状动脉粥样硬化性心脏病(简称冠心病)患者循环内皮祖细胞与血管内皮细胞生长因子的变化及其相互间的关系。方法:①对象:于2005-11/2006-10在泰山医学院聊城临床学院心内科住院并行冠状动脉造影检查确诊为冠心病患者37例和冠状动脉造影正常者(对照组)7例。其中稳定型心绞痛患者12例、不稳定型心绞痛患者14例、急性心肌梗死患者11例。②方法:采集研究对象外周血进行内皮祖细胞的分离培养,激光共聚焦显微镜鉴定FITC-UEA-I和DiLDL双染色阳性细胞为正在分化的内皮祖细胞,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内皮祖细胞的数量,测定内皮祖细胞的迁移和黏附能力。用酶联免疫吸附法检测44例入选者血浆内皮细胞生长因子水平,比较其与循环内皮祖细胞的数量、迁移和黏附能力有无相关性。结果:急性心肌梗死组内皮祖细胞集落形成数是对照组的2.7倍,其迁移能力较其他3组升高(P<0.01),但其黏附能力与不稳定型心绞痛组相比差异无显著性;不稳定型心绞痛患者内皮祖细胞数量及迁移能力较稳定型心绞痛和对照组升高(P<0.01);稳定型心绞痛患者内皮祖细胞数量及迁移、黏附能力均比对照组减低(P<0.05)。不稳定型心绞痛和急性心肌梗死患者血浆内皮细胞生长因子水平明显高于对照组(P<0.01)。内皮细胞生长因子浓度与循环内皮祖细胞数量及迁移能力呈正相关,与循环内皮祖细胞黏附能力无相关性。结论:急性心肌梗死(发病7d内)和不稳定型心绞痛可引起循环内皮祖细胞数量增多,迁移和黏附能力增强,这种变化可能与血浆内皮细胞生长因子水平增高有关。

AIM： To determine the change of endothelial progenitor cells（EPCs）and vascular endothelial growth factor （VEGF） and their relationship in patients with coronary artery disease （CAD）. METHODS： （1）Thirty-seven CAD inpatients diagnosed by coronary arteriongraphy test were enrolled from Department of Cardiology, Liaocheng Clinical School, Taishan Medical College from November 2005 to October 2006, and another 7 normal subjects following coronary arteriongraphy test were selected as control group. There were 12 subjects with stable angina pectods （SAP）, 14 subjects with unstable angina pectoris （UAP） and 11 subjects with acute myocardial infarction （AMI）. （2）EPCs were isolated from peripheral blood. EPCs were characterized as adherent cells with double positive staining by FITC-UEA-1 and DiLDL under a laser scanning confocal microscope. EPCs number and migration were assayed by colony forming unit-EPCs （CFU-EPCs） assay and modified Boyden chamber assay, respectively. EPC adhesion assay was performed, and then adherent cells were counted. The plasma VEGF level was determined in 44 subjects by enzyme linked immunosorbent assay, and then to compare the relationship with EPCs number, migration and adhesion. RESULTS： The number of CFU in the AMI group was 2.7 times of that in the control group, and the migration ability was higher than that in the other 3 groups （P 〈 0.01 ）, but the adhesion ability showed no significant difference compared with the UAP group. Number of EPCs and migration ability were higher in the UAP group than the SAP group and the control group （P 〈 0.01）. Number of EPCs, migration and adhesion ability were lower in the SAP group than the control group （P 〈 0.05）. The VEGF level in the AMI and UAP groups was significantly higher than that in control group （P 〈 0.01 ）. The VEGF level was positively correlated with number and migration ability of EPCs, and not correlated with adhesion ability. CONCLUSION： AMI （in 7 days after onset） and UAP can cause the increase of EPCs number and enhancement of migration and adhesion ability. These change can be associated with high level of plasma VEGF.