经皮冠脉介入治疗术后24h内CD34^+细胞数量的动态变化研究

Dynamic changes of number of CD34^+ cells within 24h after percutaneous coronary intervention

目的观察经皮冠脉介入治疗(PCI)术后24 h内CD34+细胞数量的动态演变过程,探究PCI对CD34+细胞数量的影响及CD34+细胞在冠脉内皮损伤修复中的作用。方法入选拟诊不稳定型心绞痛接受择期冠脉造影检查的患者65例,根据是否行PCI分为两组,介入组45例,非介入组20例。介入组于冠脉造影术后即刻即第1次球囊扩张前(0 h),第1次球囊扩张后1、3、5、7及24 h分别取外周血2 ml。非介入组于冠脉造影术后0、7及24 h分别取外周血2 ml,所取标本用于检测CD34+细胞数量。结果介入组术后7 h时CD34+细胞数量开始升高,较0 h升高了28%(266.22±132.33 vs 208.13±82.84,P<0.01);24 h较0 h升高了59%(332.47±142.16 vs 208.13±82.84,P<0.01);非介入组0 h时CD34+细胞数量较介入组高(497.85±164.69 vs208.13±82.84,P<0.01);非介入组各时间点CD34+细胞数量差异无统计学意义,并未表现时间依赖性动态变化。结论不稳定型心绞痛患者PCI术后CD34+细胞数量于术后7 h开始升高,至24 h时达到高峰,可能参与PCI过程所致内皮损伤的修复;冠脉病变程度较重的患者具有较低水平的CD34+细胞数量。

【Objective】To observe the dynamic changes of the number of CD34^＋cells within 24 h after percutaneous coronary intervention（PCI）, and to explore the effect of PCI on the numbers of CD34^＋cells and their role in coronary endothelial damage repair.【Methods】According to whether receiving interventional treatment, 65 cases with suspected unstable angina undergoing elective CAG were divided into 2 groups： the intervention group（n =45）and the non-PCI group（n =20）. 2 ml of peripheral blood were taken from the cases of the intervention group at the time of 0, 3, 5, 7 and 24 h after the first balloon expansion. 2 ml of peripheral blood were taken from the cases of the non-PCI group at the time of 0, 7 and 24 h after CAG. The peripheral blood was used to detect the number of CD34^＋cells.【Results】The number of CD34^＋cells at 7 h in the interventional group increased by 28% compared with that at 0 h [（266.22 ±132.33） vs（208.13 ±82.84）, P〈0.01], it increased by 59% at 24 h compared with that at 0 h [（332.47±142.16） vs（208.13±82.84）, P〈0.01]. The number of CD34^＋ cells of the non-PCI group was significantly higher than that of the intervention group at 0 h [（497.85±164.69） vs（208.13±82.84）, P〈0.01]. But there was no significant difference in the number of CD34^＋cells at different time points of the non-PCI group. It did not show a time-dependent change in the non-PCI group.【Conclusions】The number of CD34^＋cells in the patients with unstable angina after percutaneous coronary intervention has a time-dependent change. The number of CD34^＋cells begins to increase at 7 h after PCI, and reaches the peak at 24 h, which may take part in the repair of the coronary endothelial injury induced by PCI. Patients with severer CHD have fewer CD34^＋cells.