外周血内皮祖细胞数量和功能的变化与颈动脉粥样硬化斑块性质的关系

The relationship between peripheral blood endothelial progenitor cell counts and function and carotid atherosclerotic plaque nature

目的探讨颈动脉粥样硬化斑块性质和外周血内皮祖细胞功能和数目的变化关系研究。方法前瞻性研究2016年6月至2017年3月广东省第二人民医院心内科收治的颈动脉粥样斑块患者80例,均予以头颅磁共振成像或X线计算机断层扫描、病理检查、颈动脉彩色多普勒超声检查,根据颈动脉粥样硬化斑块性质分组,分为硬斑块组(n=42)、软斑块组(n=38),同时选择健康查体者40名作为正常对照组,均采集10 ml肘部静脉血,密度梯度离心法得到单核细胞,培养采集贴壁细胞,予以激光共聚焦显微镜鉴定,评估软斑块组和硬斑块组的内皮祖细胞数目、迁移能力、增殖能力、粘附能力。结果正常对照组增殖细胞数(0.847±0.037)个、迁移细胞数(27.697±8.248)个、粘附细胞数(46.184±7.876)个,明显高于硬斑块组[分别为(0.647±0.019)、(18.643±3.289)、(32.165±4.325)个]及软斑块组[分别为(0.679±0.023)、(23.576±6.327)、(40.587±6.523)个](P均<0.001);而硬斑块组增殖、迁移及粘附细胞数均低于软斑块组(P均<0.001)。结论颈动脉粥样硬化斑块的性质与外周血内皮祖细胞数目和功能密切相关,硬斑块颈动脉粥样硬化患者外周血内皮祖细胞数目较少,其增殖、迁移、粘附能力受损。

Objective To explore relationship between the nature of carotid atherosclerotic plaque and the number and function of endothelial progenitor cells in peripheral blood. Methods A prospective study of 80 carotid atherosclerotic plaque patients were selected from June 2016 to March 2017 in Guangdong Second Provincial General Hospital.All patients were examined with Cranial magnetic resonance imaging or X-ray computed tomography, pathological examination, carotid artery color Doppler ultrasonography.Patients were divided into hard plaque group (n=42) and soft plaque group (n=38) according to the nature of carotid atherosclerotic plaque.Forty healthy subjects were selected as controls.Monocytes were obtained from 10 ml of elbow venous blood by density gradient centrifugation.Adherent cells were cultured and identified by confocal laser microscopy.The number, migration, proliferation and adhesion of EPCs in soft plaque group and hard plaque group were evaluated. Results The number of proliferating cells(0.847±0.037), migrating cells(27.697±8.248) and adherent cells(46.184±7.876) in the normal control group were significantly higher than those in the hard plaque group ((0.647±0.019),(18.643±3.289),(32.165±4.325)) and the soft plaque group ((0.679±0.023),(23.576±6.327),(40.587±6.523))(all P<0.001), while the proliferation, migration and adherent cells in the hard plaque group were lower than those in the soft plaque group (all P<0.001). Conclusion The nature of carotid atherosclerosis plaque is closely related to the number and function of endothelial progenitor cells in peripheral blood.The number of endothelial progenitor cells in carotid atherosclerosis patients with hard plaque is small, and their proliferation, migration and adhesion ability are impaired.