冠状动脉介入治疗心肌梗死患者外周血内皮祖细胞与血管内皮生长因子的变化

Dynamic changes of endothelial progenitor cells and vascular endothelial growth factor in patients with myocardial infarction after percutaneous transluminal coronary intervention

目的观察急性心肌梗死（AMI）患者经皮冠状动脉介入治疗（PCI）术前后血浆内皮祖细胞数与血管内皮生长因子（VEGF）水平的变化规律方法采用酶联免疫吸附法（ELISA）分别检测50例AMI患者PCI治疗前后血浆VEGF水平，同时利用流式细胞术检测外周血内皮祖细胞比例。结果内皮祖细胞比率PCI术后（4．15±0．22）％明显高于术前（0．59±0．02）％（t=4．9056，P〈0．05），且升高幅度与患者冠状动脉病变支数（r=0．45，P％0．05）、冠状动脉病变程度（r=0．76，P％0．01）、左室舒张末期内径（r=0．68，P〈0．01）、射血分数（r=0．75，P〈0．01）之间呈正相关；VEGF水平PCI术后水平（506±120）ug／L明显高于术前（204±98）μg／L（P〈0．01），且与冠状动脉病变程度（r=0．66，P＜0．01）、左室射血分数（r=0．90，P〈0．01）之间呈正相关；内皮祖细胞上升幅度与VEGF升高在PCI术后短时间（24h内）之间存在相关（r=0．56，P％0．01）。结论AMI患者PCI术前后内皮祖细胞与VEGF的变化可以评估疗效及预后。

Objective To observe the dynamic changes of endothelial progenitor cells （EPC） and vascular endothelial growth factor （VEGF） in the patients with acute myocardial infarction （AMI） after percutaneous transluminal coronary intervention （PCI）. Methods The level of VEGF before and after PCI in 50 cases with AMI were determined by fluorescence immunoassay and enzyme-linked immunosorbnent assay （ELISA）, and the ratio of EPC in flood was checked by flow cytometry. Results The level of EPC was higher after PCI than before PCI[（4.15±0.22）% vs. （0.59 0.02） %, P〈0. 013, and there were positive correlations between EPC and number of coronary artery disease （r= 0.45, P 〈 0.05）, coronary artery lesions （ r = 0.76, P 〈 0.01 ）, left ventricular enddiastolic diameter （r= 0.68, P〈0.01）, ejection fraction （r= 0.75, P〈0.01）. The VEGF levels after PCI was increased [（506±120）μg/L vs. （204±98）μg/L, P〈0. 013, and its level was positively related with coronary lesions （r= 0.66, P〈 0.01）, left ventricular ejection fraction （r = 0.90, P〈 0.01）. There was association between rising rates of EPC and VEGF in a short time after PCI within 24 h period （r=0.56, P〈0.01）. Conclusions The clinical efficacy and prognosis can be assessed by the changes of VEGF level and EPC ratio before and after PCI operation in AMI patients.