冠脉介入治疗对不稳定性心绞痛内皮功能及内皮祖细胞的影响

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。

Influence of percutaneous coronary intervention on endothelial progenitor cells and endothelial function in patients with unstable angina pectoris

Objective: To investigate changes of the counts and functional activities of endothelial progenitor cells(EPCs) after percutaneous coronary intervention(PCI) in patients with unstable angina pectors(UA);Methods:Patients with UA were randomly assigned to PCI group(n=30) and pure drug group(n=26).The number of circulating CD34+/KDR+ of peripheral blood mononuclear cells(PBMCs) of two groups were counted.After 14 days culture of PBMCS,the FITC-UEA/DiI-acLDL double positive cells were endothelial progenitor cells,and the CFU forming,proliferation and migration were observed.The endothelium dependent vasodilation with high resolution vascular ultrasound were measured in two groups.Results:Compare to the control group,the number and function activities of EPCs and endothelial function in experimental group were significantly increased in patients with UA after the PCI.Conclusion: Implantion eluting stent can increase the number of endothelial progenitor cells and promote functional activities,thus can improve artery endothelial function.