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目的:探讨不稳定性心绞痛患者行冠脉介入治疗前后循环内皮祖细胞(EPCs)数量及功能与血管内皮功能的关系。方法:将入选患者分为二组,第一组为不稳定性心绞痛患者行冠脉介入治疗组,另一组为不稳定性心绞痛患者单纯药物组,均在入院时、术后6个月采用流式细胞仪测定外周血中CD34+/KDR+单个核细胞的水平;采取外周血分离单个核细胞体外诱导培养2周,FITC-UEA-1和DiI-acLDL免疫荧光染色双阳性细胞为正在分化的内皮祖细胞,分别观察其集落形成、增殖及迁移能力;采用高分辨率二维超声检测肱动脉血流介导的内皮依赖性血管舒张功能(FMD)。结果:与术前及对照组相比,术后6个月实验组FMD有明显改善,外周血内皮祖细胞的数量及功能亦有明显增加(P<0.05);直线相关分析显示PCI术后FMD与外周血内皮祖细胞的数量呈正相关(r=0.759)。结论:冠脉介入治疗后不稳定性心绞痛患者的内皮功能及内皮祖细胞数量及功能在术后6个月均较术前及对照组增加,说明冠脉介入治疗通过内皮祖细胞的动员有助于改善动脉血管内皮功能。
Objective: To investigate the relationship between the number and function of circulating endothelial progenitor cells (EPCs) and vascular endothelial function before and after coronary intervention in patients with unstable angina pectoris. Methods: The selected patients were divided into two groups, the first group was treated with coronary intervention in patients with unstable angina pectoris and the other was simple drug group with unstable angina pectoris, both at admission and 6 months after operation The level of CD34 + / KDR + mononuclear cells in peripheral blood was measured by flow cytometry. Peripheral blood mononuclear cells were isolated and cultured in vitro for 2 weeks. The double positive cells immunofluorescent staining with FITC-UEA-1 and DiI-acLDL were differentiated endothelium Progenitor cells were observed for colony formation, proliferation and migration. The brachial artery-mediated endothelium-dependent vasodilatation (FMD) was measured by high resolution two-dimensional ultrasound. Results: Compared with the preoperative and control groups, FMD in experimental group was significantly improved at 6 months after operation, and the number and function of endothelial progenitor cells in peripheral blood were also significantly increased (P <0.05). The linear correlation analysis showed that FMD And the number of peripheral blood progenitor cells was positively correlated (r = 0.759). Conclusions: Endothelial function, endothelial progenitor cell number and function of EPCs in patients with unstable angina pectoris after coronary intervention are both higher than those in preoperative and control groups at 6 months after coronary angioplasty, indicating that coronary artery intervention can be helpful to mobilize endothelial progenitor cells To improve arterial endothelial function.