冠心病患者冠状动脉病变严重程度与内皮祖细胞及血管内皮功能的相关性分析

目的探讨冠心病患者循环血内皮祖细胞(EPCs)数量、血流介导的内皮依赖性血管舒张功能(FMD)的变化及其与冠状动脉病变严重程度的相关性。方法对159例患者根据冠状动脉造影结果,分为冠心病组(101例)及对照组(58例),采用流式细胞术检测所有入选者EPCs水平,并采用高分辨率血管超声法检测其肱动脉FMD。冠心病组依据SYNTAX积分进一步分为低危、中危和高危3个亚组,比较高危、中危、低危三组之间EPCs数量及FMD的差异及与冠状动脉病变程度的相关性。结果与对照组比较,冠心病组患者EPCs数量显著减少,肱动脉FMD亦明显减低(P<0.05),循环血EPCs数量与肱动脉FMD呈显著正相关趋势(r=0.41,P<0.01)。各亚组之间,低危组与高危组比较,EPCs数量水平及FMD有统计学差异(P<0.05),中危组与低危组、中危组与高危组之间比较,EPCs数量水平及FMD均无显著性差异(P>0.05)。EPCs数量及FMD均与冠状动脉造影SYNTAX评分呈负相关(r=-0.381,P<0.01;r=-0.317,P<0.01)。结论冠心病患者循环血EPCs数量较健康人群显著减少,血管内皮功能显著低下,且与冠状动脉病变严重程度呈负相关。

Correlation analysis between endothelial progenitor cells,flow-mediated-dilation and severity of coronary artery lesion in patients with coronary heart disease

Objective To explore the variance of endothelial progenitor cells（EPCs） and flow-mediated-dilation（FMD） in peripheral blood in patients with coronary heart disease（CHD） and their relationship with severity of coronary artery stenosis. Methods 159 patients who underwent coronary angiography were divided into CHD group（101 patients） and normal control group（58 patients）.The levels of EPCs was detected for each patient by flow cytometry. FMD in brachial artery were measured by ultrasonography in both groups.According to SYNTAX score, CHD group were divided into three subgroups, low-risk group, middle-risk group and high-risk group. Comparing the number of circulating EPCs and FMD in each subgroups and their relationship were analyzed with severity of coronary artery stenosis. Results Compared with those people without CHD, the levels of EPCs in CHD group obviously reduced and FMD was significantly lower（P〈0.05）, the two were positive correlation（r=0.41, P〈0.01）. Comparing the subgroups, the numbers of EPCs and FMD in the high-risk group were significant lower than those of the low-risk group.While no such difference were found between the middle-risk group with the high-risk group or the low-risk group. EPCs and FMD were negatively correlated trend with SYNTAX score（r=-0.381, P〈0.01 and r=-0.327, P〈0.01）. Conclusion The number of EPCs in patients with coronary heart disease is obviously reduced compared with healthy people, vascular endothelial function is significantly lower, and both are negatively correlated with severity of coronary artery stenosis.