冠心病患者循环内皮祖细胞与基质细胞衍生因子-1α的变化

目的探讨循环内皮祖细胞(EPCs)与血浆基质细胞衍生因子-1α(SPF-1α)在冠心病中的作用及其临床应用价值。方法将44例患者分为稳定型心绞痛(SAP)组(n=12)、不稳定型心绞痛(UAP)组(n=14)、急性心肌梗死(AMI)组(n=11)及对照组(n=7)。采集患者外周血进行EPCs的分离培养,激光聚焦显微镜鉴定FITC-UEA-I和DiLDL双染色阳性细胞为正在分化的EPC,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EPCs的数量,测定EPCs的迁移和黏附能力。用酶联免疫吸附法检测各组血浆SDF-1α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AMI组EPCs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UAP组相比差异无统计学意义(P>0.05);UAP组患者EPCs数量及迁移能力较SAP组和对照组升高(P<0.01);SAP组患者EPCs数量及迁移、黏附能力均比对照组减低(P<0.05)。与对照组相比,UAP和AMI组患者血浆SDF-1α水平明显降低(P<0.01)。SDF-1α浓度与循环EPCs数量及迁移能力呈负相关,与循环EPCs黏附能力无相关性。结论AMI(发病7d内)和UAP可引起循环EPCs数量增多,迁移和黏附能力增强,这种变化可能与冠状动脉粥样斑块不稳定、消耗循环SDF-1α有关。

The change of circulating endothelial progenitor cells and stromal cell derived factor-1α in patients with coronary artery disease

Objective To investigate the change of endothelial progenitor cells(EPCs)and stromal cell derived factor-1α (SDF-1α) in patients with coronary artery disease (CAD) and their clinical significance.Methods 44 patients with CAD were divided into 4 groups:stable angina pectoris (SAP) group (n=12),unstable angina pectoris (UAP) group (n=14),acute myocardial infarction (AMI) group (n=11) and control group (n=7).Total mononuclear cells were isolated from peripheral blood by Ficoll density gradient centrifugation,EPCs were identified as differentiating cells for double staining positive of FITC-UEA-I and DiLDL and lectin binding by direct fluorescent staining under a laser scanning confocal microscope.EPCs number and migratory function were detected by colony forming unit and modified Boyden chamber assay,respectively.EPCs adhesion assay was performed by replating those on fibronectin-coated dishes,then adherent cells were counted. The plasma levels of SDF-1α were determined by ELISA.Results The number of CFU and migration,adhesion activity of circulating EPCs in AMI and UAP group was significantly higher than that in SAP group,but adhesion activity of EPCs was simillar to that in UAP group.The number of CFU and migration,adhesion activity of EPCs was decreased in SAP group,as compared with that in other groups.The SDF-1α levels in AMI and UAP group were significantly lower than that in control group (P<0.01).The levels of SDF-1α were negatively correlated with the number of circulating CFU and its migratory activity,howe-ver,which were not correlated with the adherent activity of circulating EPCs.Conclusion The number of CFU and migratory,adhesive activity of EPCs in AMI (with 7 days of onset) and UAP patients are significantly higher than those of SAP patients.This changes might be related to unstable atheromatous plaque and consumption of plasma SDF-1α.