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目的:观察冠状动脉粥样硬化性心脏病(简称冠心病)患者循环内皮祖细胞与血管内皮细胞生长因子的变化及其相互间的关系。方法:①对象:于2005-11/2006-10在泰山医学院聊城临床学院心内科住院并行冠状动脉造影检查确诊为冠心病患者37例和冠状动脉造影正常者(对照组)7例。其中稳定型心绞痛患者12例、不稳定型心绞痛患者14例、急性心肌梗死患者11例。②方法:采集研究对象外周血进行内皮祖细胞的分离培养,激光共聚焦显微镜鉴定FITC-UEA-I和DiLDL双染色阳性细胞为正在分化的内皮祖细胞,通过集落形成试验、改良的Boyden小室和黏附能力测定实验计数内皮祖细胞的数量,测定内皮祖细胞的迁移和黏附能力。用酶联免疫吸附法检测44例入选者血浆内皮细胞生长因子水平,比较其与循环内皮祖细胞的数量、迁移和黏附能力有无相关性。结果:急性心肌梗死组内皮祖细胞集落形成数是对照组的2.7倍,其迁移能力较其他3组升高(P<0.01),但其黏附能力与不稳定型心绞痛组相比差异无显著性;不稳定型心绞痛患者内皮祖细胞数量及迁移能力较稳定型心绞痛和对照组升高(P<0.01);稳定型心绞痛患者内皮祖细胞数量及迁移、黏附能力均比对照组减低(P<0.05)。不稳定型心绞痛和急性心肌梗死患者血浆内皮细胞生长因子水平明显高于对照组(P<0.01)。内皮细胞生长因子浓度与循环内皮祖细胞数量及迁移能力呈正相关,与循环内皮祖细胞黏附能力无相关性。结论:急性心肌梗死(发病7d内)和不稳定型心绞痛可引起循环内皮祖细胞数量增多,迁移和黏附能力增强,这种变化可能与血浆内皮细胞生长因子水平增高有关。
Objective: To observe the changes of circulating endothelial progenitor cells and vascular endothelial growth factor in patients with coronary atherosclerotic heart disease (referred to as coronary heart disease) and their relationship with each other. Methods: ① Subjects: From March 2005 to October 2006, 37 patients with CAD and 7 patients with normal coronary arteries (control group) underwent in-hospital coronary angiography in Liaocheng Clinical College of Taishan Medical College. Among them, there were 12 patients with stable angina pectoris, 14 patients with unstable angina pectoris and 11 patients with acute myocardial infarction. Methods: Peripheral blood progenitor cells were collected for the culture of endothelial progenitor cells. Confocal laser scanning microscopy was used to identify the differentiated endothelial progenitor cells, FITC-UEA-I and DiLDL double positive staining cells. The colony formation assay, modified Boyden chamber and Adhesion assay assay counts the number of endothelial progenitor cells and determines the migration and adhesion of endothelial progenitor cells. The levels of plasma endothelial cell growth factor (VEGF) in 44 patients were detected by enzyme-linked immunosorbent assay (ELISA), and their correlations with circulating endothelial progenitor cells, migration and adhesion were compared. Results: The number of EPCs in acute myocardial infarction group was 2.7 times that of the control group, and its migration ability was higher than that of the other 3 groups (P <0.01), but there was no significant difference in the adhesion ability between the group and the unstable angina group ; The number and migration ability of endothelial progenitor cells in unstable angina patients were higher than that in patients with stable angina pectoris and control group (P <0.01); the number of EPCs, the migration and adhesion capacity of patients with stable angina pectoris were lower than those in control group (P <0.05) ). The levels of plasma endothelial cell growth factor in patients with unstable angina and acute myocardial infarction were significantly higher than those in the control group (P <0.01). The concentration of endothelial cell growth factor was positively correlated with the number of circulating endothelial progenitor cells and migration ability, but not with the ability of circulating endothelial progenitor cells. CONCLUSION: Acute myocardial infarction (within 7 days of onset) and unstable angina pectoris can cause an increase in the number of circulating endothelial progenitor cells and an increase in migration and adhesion. This change may be related to an increase in plasma levels of endothelial cell growth factor.