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目的:探讨冠心病患者循环内皮祖细胞与冠脉病变轻重程度的临床意义,为冠心病的防治提供科学依据。方法:选择经过冠状动脉造影检查确诊为冠心病的患者35例和冠脉造影检查阴性的患者40例。分别采集患者入院当天和入院48 h空腹血15 mL,进行内皮祖细胞(EPCSs)的分离培养,观察细胞培养1周内细胞形态;流式细胞术测定CD133含量。结果:EPCSs在不同培养天数中依次呈现小圆形、椭圆形、短梭形以及长梭型形状。冠心病组CD133细胞计数与冠脉病变程度(单支、2~3支、3支以上)进行Sperm an秩相关分析,发现CD133细胞含量与病变程度呈负相关(r=-0.819,P<0.01)。同一冠脉病变程度组在不同采血时间EPCs培养的CD133含量比较,入院48 h采血测的CD133数量比入院当天采血的CD133含量均有所增加,并且差异均具有统计学意义(P<0.05);但冠脉造影阴性组在不同采血时间CD133含量差异无统计学意义。相同采血时间(入院当天和入院48 h)EPCs培养的CD133含量在三组间比较,冠脉病变组(单支组和≥2支组)与冠脉造影阴性组相比较差异均具有统计学意义(P<0.05);单支病变组和多支病变组的差异无统计学意义,但随着病变支数的增多CD133的数量下降。结论:循环内皮细胞的损伤与冠心病病情的轻重程度有关,循环内皮组细胞水平表达变化可能预测冠心病病情变化,为临床上冠心病合理治疗提供一定的依据。
Objective: To investigate the clinical significance of circulating endothelial progenitor cells and coronary artery disease in patients with coronary heart disease, and provide a scientific basis for the prevention and treatment of coronary heart disease. Methods: 35 patients with coronary heart disease confirmed by coronary angiography and 40 patients with negative coronary angiography were selected. The patients were admitted on the day of admission and admission of 48 h fasting blood 15 mL, endothelial progenitor cells (EPCSs) were isolated and cultured to observe the cell morphology within 1 week culture; CD133 flow cytometry. Results: EPCSs showed small round shape, elliptical shape, short shuttle shape and long shuttle shape in different culture days. Coronary heart disease group CD133 cell count and coronary lesions (single, 2 to 3, 3 or more) Sperm an rank correlation analysis found that CD133 cell content and the degree of lesion was negatively correlated (r = -0.819, P <0.01 ). Compared with the CD133 levels of EPCs in the same coronary lesion group, the amount of CD133 in blood collected at 48 h after admission was higher than that of CD133 on the day of admission, and the difference was statistically significant (P <0.05). However, there was no significant difference in CD133 content between different angiography negative groups at different sampling times. The CD133 levels of EPCs in the same blood collection time (admission day and admission 48 h) were significantly different among the three groups, the difference between coronary artery lesion group (single group and group ≥2) and coronary angiography negative group were statistically significant (P <0.05). There was no significant difference between the single-vessel disease group and the multi-vessel disease group, but the number of CD133 decreased with the increase of the lesion count. Conclusion: The damage of circulating endothelial cells is related to the degree of severity of coronary heart disease. The changes of the level of circulating endothelial cells may predict the change of coronary heart disease, and provide some evidences for the rational treatment of coronary heart disease in clinic.