流式细胞术检测CD11b在PTCA手术前后的临床应用

Clinical application of CD11b determination by flow cytometry before and after PTCA and CA

目的探讨冠心病(CHD)患者经皮冠状动脉腔内成形术(PTCA)、冠状动脉造影(CA)手术前及术后中性粒细胞(PMN)和单核细胞CD11b表达变化及临床意义。方法选择66例CHD患者,其中41例行PTCA手术、25例行CA手术,23例健康体检者为研究对象。采用流式细胞仪检测健康体检者及CHD患者PTCA和CA手术前3d、手术当天、术后30min、术后1d、术后3d外周血PMN和单核细胞表面CD11b的表达。结果CHD患者外周血PMN和单核细胞CD11b平均荧光强度(MFI)较正常对照组明显升高,差异具有显著性(P<0.05)。PTCA手术后PMN和单核细胞CD11bMFI明显升高,与手术前3d和手术当天CD11b含量具有显著性差异(P<0.05)。单核细胞CD11bMFI在手术后1d较手术后30min高表达,差异具有显著性(P<0.05)。施行CA前后CHD患者外周血PMN和单核细胞CD11b的表达没有显著性变化(P>0.05)。结论PMN和单核细胞表面CD11b含量评价选择平均荧光强度比选择百分率更能反映CD11b的变化。CHD患者PTCA术后确有炎症反应发生,CD11b表达可作为PTCA后炎症反应发生有临床应用价值的指标。

Objective： To investigate changes in the expression of CD11b on neutrophils and monocytes before and after PTCA and CA in patients with coronary heart disease （CHD）. Methods ： Fortyone patient sunderwent percutaneous coronary angioplasty （PTCA）. Twenty-five patients underwent coronary angiographic （CA）. Twenty-three people were healthy as control. Peripheral venous blood samples were obtained at intraday, 30min, 24h and 72h before and after PTCA and CA. Flow-cytometric methods were used to measure CD11b on neutrophils and monocytes. Rsults： The levels of CDllb on neutrophils and monocytes were significantly higher in UA patients with CHD compared to controls （P〈 0. 05）. At 72 hours after PTCA, the levels of CDllb on neutrophils and monocytes were significantly higher than at 72 hours before and intraday PTCA （P〈0.05）. High levels of the monocyte receptor CDllb were noted in patients 24h after PTCA compared to 30min after PTCA （P〈0.05）. There is no differences of CD11b on neutrophils and monocytes before and after CA in patients with CHD （P〈 0. 05）. Conclusion： The mean intensity of fluorescence is better than percentage to evaluate the content of CD11b on neutrophils and monocyte. PTCA triggers leukocytes activation in circulation. CDllb can reflect the acute inflammatory activity aridses which arises after PTCA.