长期血液透析慢性肾功能衰竭患者内皮祖细胞的变化及其与Framingham危险评分的关系

Change of Endothelial Progenitor Cells in Hemodialysis Patients and its Relation with Framingham Risk Score

目的检测血液透析患者内皮祖细胞数量(EPCs)和功能的改变,并探讨其与Framingham危险评分的关系。方法采用密度梯度离心法分离培养慢性肾功能衰竭长期血液透析患者和对照组外周血单个核细胞,将其接种在人纤维连接蛋白包被培养板,7 d后取贴壁细胞进行Di-LDL和FITC-UEA-I双染色.并通过流式细胞仪检测其表面标志CD34、CD133、KDR,以鉴定EPCs。采用改良的Boyden小室、黏附功能检测评价其迁移和黏附能力,并与10 a Framingham危险评分进行统计学分析。结果长期血液透析患者EPCs的数量和迁移、黏附功能均低于对照组,差别有统计学意义(P<0.05);10 a Framingham危险评分与患者EPCs的数量和迁移、黏附功能分别呈负相关(r=-0.623,-0.658,-0.625,P<0.05)。结论长期血液透析患者的EPCs数量和功能降低,存在血管新生和内皮修复的缺陷,增加了患冠心病的风险。

Objective To investigate the number and activity changes of endothelial progenitor cells （EPCs） in hemodialysis patients, and explore its correlation with the risk factors of coronary heart disease, nethords Total mononuclear cells （MNCs） were isolated from peripheral blood of patients with chronic renal failure in long-term hemodialysis and from a normal control group by Ficoll density gradient centrifugation and then were plated on humanfibronectin-coated dishes.After 7 days of culture, EPCs were characterized as adherent cells by double staining with FITC-UEA-I and DI-LDL, and were further identified by the expression of CD34, CD133 and KDR with flow cytometry. EPCs migration was determined with modified Boyden chamber assay. EPCs adhesive assay was performed by replanting EPCs on humanfibronectin-coated plates and then counting the adherent cells. The relationship of the EPCs＇ number and activity with Framingham Risk Score of ten years was also be assessed. Results Number of EPCs and the migratory ＆ adhesive capacity were significantly lower in patients than in the control （P〈O.05）; Framing, ham Risk Score of ten years was significantly negative correlated with EPCs level and its migration and adhesive activity （r =-0.623, -0.658, -0.625, P〈O.05）. Conclusion The number and activity of EPCs were decreaced in patients with chronic renal failure in long-term hemodialysis; neovascularization and repalrment of damaged endothelium were impaired in these patients, these were related with the increased risk of coronary heart disease.