腹膜透析患者外周血内皮祖细胞变化及相关因素分析

Changes of the peripheral blood endothelial progenitor cells in peritoneal dialysis patients and its impact factors

目的检测持续不卧床腹膜透析（CAPD）患者外周血内皮祖细胞（CEPCs）数量和功能的改变，探讨CAPD患者外周血EPCs变化的特点及其影响因素。方法选取CAPD患者25例及健康对照30例，采用Ficoll密度梯度离心法分离、培养外周血单个核细胞。流式细胞术检测受试者静脉血单个核细胞中CD34、CD133和KDR阳性细胞，采用免疫荧光Dil-AcLDL和FITC-UEA-1双染色进行阳性细胞鉴定，检测外周血EPCs的数量及其增殖、黏附、迁移能力的变化。分析EPCs数量与晚期糖基化终末产物（AGEs）、血清半胱氨酸（Hcy）、C反应蛋白（CRP）水平的相关关系。结果与对照组相比，CAPD组患者外周血EPCs的数量及其增殖、黏附能力均显著降低（均P〈0．05），血清AGEs、Hcy及CRP水平明显升高，与EPCs数量呈负相关（均P〈0．05）。结论长期腹膜透析患者的外周血EPCs数量和活性降低，与血清AGEs、Hey及CRP水平呈负相关关系。

Objective To investigate the number and activities changes of peripheral blood endothelial progenitor cells （EPCs） in continuous ambulatory peritoneal dialysis （CAPD） patients, and explore the connection between EPCs＇ number and the levels of advanced glycosylation end products （AGEs）, homocysteine （Hcy） and C- reactive protein （CRP）. Methods Twenty-five CAPD patients and thirty healthy volunteers were involved. Total mononuclear cells （MNCs） were isolated from peripheral blood of patients. EPCs were characterized as adherent cells by double staining of FITC- UEA- 1 and DiL-AcLDL binding, and were further demonstrated by positive cells of CD34, CD133 and KDR using flow cytometry. The abilities of cell proliferation, adhesion and migration were further observed by fluorescent microscope. The correlations between the CEPCs＇ number and the levels of AGEs, Hey and CRP were analyzed. Results The number and activities including migration and adhesion of EPCs in CAPD group were significantly lower than control group （P 〈 0.05）. The levels of serum AGEs, Hcy and CRP in CAPD patients were increased （all P 〈 0.05） and had negative correlation with EPCs＇ number. Conclusions The number and activities of EPCs decrease in patients with CAPD, and EPCs＇ number is negatively correlated to the levels of AGEs, Hcy and CRP.