烟雾病治疗中外周血内皮祖细胞及其生物学特性的研究

Studies on peripheral blood endothelial progenitor cells and their biological characteristics in the treatment of moyamoya disease

目的探讨烟雾病患者在接受保守治疗和手术治疗前后外周血中内皮祖细胞(endothelial progenitor cells,EPCs)的变化情况。方法选取2015年6月至2017年6月在沧州市中心医院接受治疗的烟雾病患者60例作为研究对象。其中接受药物保守治疗患者30例为保守治疗组,接受颅内外脑血管搭桥手术治疗患者30例为手术治疗组。所有患者均于治疗前和治疗后6个月留取外周血。将外周血经密度梯度离心法分离出单个核细胞,利用流式细胞仪检测外周血中内皮祖细胞数量。分别检测两组内皮祖细胞的增殖和迁移能力。结果手术治疗组治疗6个月后的内皮祖细胞数量较治疗前降低(t=5.761,P<0.05),手术治疗组较保守治疗组治疗后6个月的内皮祖细胞数量更低(t=4.202,P<0.05)。保守治疗组和手术治疗组内皮祖细胞治疗前后的增值能力变化差异无统计学意义(t=0.540、0.820,P>0.05),两组迁移能力变化也无统计学意义(t=0.900、-0.361,P>0.05)。结论手术治疗较保守治疗能降低烟雾病患者外周血中内皮祖细胞的数量,但对于内皮祖细胞增殖和迁移能力无明显影响。

Objective To investigate the changes of endothelial progenitor cells(EPCs)in peripheral blood of patients with moyamoya disease before and after conservative treatment or surgical treatment.Methods 60 cases of moyamoya disease treated in Cangzhou central hospital from June 2015 to June 2017 were selected as the research subjects.30 patients who received conservative treatment were treated as conservative treatment group,and 30 patients received intracranial and extracranial bypass surgery as operation group.Peripheral blood was collected from all patients before treatment and 6 months after treatment.Mononuclear cells were isolated from peripheral blood by density gradient centrifugation,and the number of endothelial progenitor cells in peripheral blood was detected by flow cytometry.The proliferation and migration ability of two groups of endothelial progenitor cells were detected.Results Compared with that before treatment,the number of endothelial progenitor cells in the operation group decreased at 6 months after treatment(t=5.761,P<0.05).The number of endothelial progenitor cells in the operation group was lower than that in the conservative treatment group at 6 months after treatment(t=4.202,P<0.05).The difference was not statistically significant in the proliferation(t=0.540,0.820,P>0.05)and migration(t=0.900,-0.361,P>0.05)of endothelial progenitor cells between the conservative treatment group and the operation group.Conclusion Surgical treatment reduces the number of endothelial progenitor cells in peripheral blood of patients with moyamoya disease,but has no significant effect on the proliferation and migration of endothelial progenitor cells.