缺血性心脏病心力衰竭患者外周血干细胞数量与心功能的相关性

目的 观察缺血性心脏病心力衰竭(心衰)患者外周血干细胞(PBSC)数量与心功能指标--NYHA心功能分级、左室射血分数(LVEF)、N末端B型利钠肽原(NT-proBNP)的关系.方法 选择缺血性心脏病心衰患者199例,临床评价NYHA心功能分级、彩色心脏多普勒超声检测LVEF,电化学发光法测定NT-proBNP,流式细胞仪间接法检测PBSC数量,运用相关性分析和逐步回归法分析心功能与PBSC数量的关联.结果 PBSC数量在不同NYHA心功能分级缺血性心脏病心衰患者之间的差异具有统计学意义(F=12.12,P＜0.01).心功能Ⅳ级患者PBSC数量明显低于Ⅱ、Ⅲ级患者,差异有统计学意义(P＜0.01).LVEF与PBSC呈正相关(r=0.35,P=0.001),NT-proBNP与PBSC呈负相关(r=-0.39,P=0.009).LVEF、NT-proBNP两者对PBSC数量有显著影响(Beta分别为0.14、-0.25,95%CI分别为-0.01～0.02、-0.18～-0.04,分别为P＜0.05、P＜0.01).结论 PBSC数量与缺血性心脏病心衰患者心功能有关.

Association between the number of peripheral blood stem cells and cardiac function index in patients with ischemic heart failure

Objective To observe the association between the number of peripheral blood stem cells (PBSC)and cardiac function index(NYHA grade,left ventricular ejection fraction,LVEF,N-terminal-pro B-type Natriuretic Peptide,NT-proBNP)in patients with ischemic heart failure(IHF).Methods A total of 199 patients hospitalized in our department between August 2007 and April 2008 due to IHF were included in this study.NYHA grade,LVEF(measured by echocardiography),plasma NT-proBNP and number of PBSC were analyzed.Results PBSC number was significantly decreased in proportion with increasing NYHA grade and PBSC number Was significantly lower in patients with NYHA IV than that with class Ⅱ and Ⅲ(all P＜0.01).LVEF was positively correlated with PBSC number(r=0.35,P=0.001),NT-pro BNP was negatively correlated with PBSC number(r=-0.39,P=0.009).Multiple regression analysis showed that LVEF and NT-proBNP were major determinants of PBSC(Beta=0.14,-0.25.95%CI=-0.01～0.02,-0.18- -0.04,P＜0.05.P＜0.01).Conclusion PBSC number was significantly correlated to cardiac function in IHF patients.