氯沙坦对慢性心力衰竭患者外周血内皮祖细胞的影响研究

Impact of Losartan on Peripheral Blood Endothelial Progenitor Cells in Patients with Chronic Heart Failure

目的探讨氯沙坦对慢性心力衰竭患者外周血内皮祖细胞(EPCs)的影响。方法选取2015年3月—2016年3月海南医学院第一附属医院心内科收治的慢性心力衰竭患者30例,采集患者外周血10 ml,体外培养EPCs。将体外培养的EPCs随机分为A组,B组和C组,每组10份。A组不做任何处理,B组采用氯沙坦10μmol/L进行处理,C组采用氯沙坦10μmol/L+磷脂酰肌醇3-激酶(PI3K)抑制剂10μmol/L进行处理。比较3组EPCs培养12 h、24 h、36 h、48 h、72 h 535nm波长下光密度值(OD_(535)),穿膜细胞数,苏氨酸蛋白激酶(Akt)及内皮型一氧化氮合酶(eNOS)蛋白表达量。结果时间与方法在OD_(535)上存在交互作用(P<0.05);时间在OD_(535)上主效应显著(P<0.05);方法在OD535上主效应显著(P<0.05);B组EPCs 12 h、24 h、36 h、48 h、72 h OD535高于A组、C组(P<0.05)。B组EPCs穿膜细胞数多于A组、C组(P<0.05)。B组EPCs的Akt和eNOS蛋白表达量高于A、C组(P<0.05)。结论氯沙坦可有效促进慢性心力衰竭患者外周血EPCs增殖和迁移,改善内皮细胞功能,其可能通过调节PI3K/Akt/e NOS信号通路而发挥作用。

Objective To investigate the impact of losartan on peripheral blood endothelial progenitor cells in patients with chronic heart failure. Methods From March 2015 to March 2016,a total of 30 patients with chronic heart failure were selected in the Department of Cardiology,the First Affiliated Hospital of Hainan Medical College,10 ml peripheral blood was collected from each case and endothelial progenitor cells were cultured in vitro. Cultured endothelial progenitor cells were divided into A group, B group and C group, each of 10 samples. Endothelial progenitor cells of A group did not received any intervention,endothelial progenitor cells of B group received losartan（ 10 μmol/L）, while endothelial progenitor cells of B group received losartan（ 10 μmol/L） combined with PI3 K inhibitor（ 10 μmol/L）. OD535 of endothelial progenitor cells after12 hours,24 hours,36 hours,48 hours and 72 hours of culture,number of transmembrane cells,protein expressions of Akt and e NOS were compared among the three groups. Results There was interaction between time and method in OD535 of endothelial progenitor cells（ P〈0. 05）; main effects of time and method were significant in OD535 of endothelial progenitor cells（ P〈0. 05）; OD535 of endothelial progenitor cells of B group was statistically significantly higher than that of A group and C group after 12 hours,24 hours,36 hours,48 hours and 72 hours of culture,respectively（ P〈0. 05）. Number of transmembrane cells of B group was statistically significantly more than that of A group and C group, respectively（ P〈0. 05）. Protein expressions of Akt and eNOS of B group were statistically significantly higher than those of A group and C group（ P〈0. 05）.Conclusion Losartan can effectively promote the proliferation and migration of peripheral blood endothelial progenitor cells in patients with chronic heart failure,is helpful to improve the endothelial cell function,losartan may play a role through adjusting PI3K/Akt/eNOS signal pathway.