ST段抬高性心肌梗死蛇毒纤溶酶治疗过程内皮祖细胞的变化

Alterations of peripheral blood endothelial progenitor cells from patients with ST elevation myocardial infarction after snake venom fibrinolytic enzyme therapy

目的研究ST段抬高性心肌梗死患者经蛇毒纤溶酶治疗过程中外周血中循环内皮祖细胞(EPCs)形态、数量的变化。方法选择ST段抬高性心肌梗死(STEMI)患者60例和对照组20例,分别在蛇毒纤溶酶给药前,给药3d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,用加入血管内皮生长因子和碱性成纤维细胞生长因子的RPMI-1640培养基培养细胞。用激光共聚焦显微镜初步鉴定DiL标记的乙酰化低密度脂蛋白和FITC标记的荆豆凝集素I双染色阳性细胞为EPCs;相差显微镜分析细胞形态数量变化和集落形成单位的数量。结果ST段抬高性心肌梗死患者给予蛇毒纤溶酶治疗3d后EPCs数目较治疗前明显增加,7d有所下降,但仍高于对照组,但给药前后细胞集落形成单位的数量并无变化。结论ST段抬高性心肌梗死患者给予蛇毒纤溶酶治疗后,可引起EPCs数量的增加。

Objective To investigate the morphological and quantitative alterations of peripheral blood endothelial progenitor cells （EPCs） in patients with ST elevation myocardial infarction （STEMI） after snake venom fibrinolytic enzyme therapy. Methods Sixty patients with STEMI and 20 control patients free of STEMI were enrolled in this study. The mononuclear cells were isolated from the peripheral blood of the STEMI patients before and 3 and 7 days after fibrinolytic enzyme injection. The isolated cells were cultured in RPMI1640 medium supplemented with vascular endothelial growth factor 165 （VEGF165） and basic fibroblast growth factor （bFGF）. The EPCs were characterized as adherent cells of positive for both DiL-acLDL and FITC-UEA-I by direct fluorescent staining. The cell morphology was observed and the number of the colony-forming units （CFU） was determined by phase-contrast microseope. Results The number ofthe EPCs increased obviously in patients with STEM1 3 days after fibrinolytic enzyme injection, and reduced 7 days after the injection but remained greater than that in the control group. The injection of fibrinolytic enzyme did not result obvious changes in the number of CFU in the patients with STEMI. Conclusion Snake venom fibrinolytic enzyme injection can increase the peripheral blood EPCs in patients with STEMI.