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[循环内皮祖细胞与冠心病危险因素、冠状动脉病变严重程度的关系及其临床意义]

[The relationship between circulating endothelial progenitor cells and the risk factors of CHD as well as the severity of coronary lesions, and its clinical significance].

作者信息

Cui Bin, Huang Lan, Song Yao-ming, Li Ai-min, Jin Jun, Qin Jun, Yu Xue-jun, Geng Zhao-hua

机构信息

Department of cardiology, Second Affiliated Hospital of the Third Military Medical University, Chongqing 400037, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2005 Sep;33(9):785-8.

Abstract

OBJECTIVE

To investigate the correlation between circulating endothelial progenitor cells (EPCs) and the risk factors of coronary heart disease (CHD) as well as the severity of coronary lesions, and its clinical significance.

METHODS

42 patients with CHD and 36 patients excluding CHD (control) were studied. Total mononuclear cells were isolated from peripheral blood by Ficoll density gradient centrifugation, and were cultured in M199 medium supplemented with 20% fetal bovine serum, 50 ng/ml vascular endothelial growth factor (VEGF). After 14 days cultured, the numbers of colony-forming units of EPCs were counted by phase-contrast microscope. The relationship between the number of colony-forming units of EPCs and the risk factors of CHD (such as age, gender, hypertension, hypercholesterolemia, diabetes, smoking, positive family history of CHD) as well as the severity of coronary lesions were assessed.

RESULTS

The number of risk factors of CHD was significantly correlated with a reduction of EPCs levels (r = -0.436, P = 0.014). Smoking was associated with significantly lower EPCs levels, whereas a minor but nonsignificant reduction of EPCs levels was detected in the presence of gender, hypertension, and a positive family history of CHD. It was observed that low density lipoprotein (LDL) and uric acid were negatively correlated with the number of colony-forming units of circulating EPCs (P < 0.05). A correlation existed between age, high density lipoprotein, apoprotein A and levels of circulating EPCs, however, this relation was not statistically significant. The number of colony-forming units of circulating EPCs in CHD groups was significantly lower than those in control group (12.8 +/- 6.34 versus 37.0 +/- 5.5, P < 0.001); and the circulating EPCs level of coronary artery lesion group (including single, double, triple vessels disease) was significantly lower than that of control group (P < 0. 01).

CONCLUSIONS

The level of circulating EPCs was inversely associated with the risk factor scores of CHD and the severity of coronary artery lesion. These finding imply that endothelial injury in the absence of sufficient circulating EPCs may affect the degree of the heart disorder and the clinical situation.

摘要

目的

探讨循环内皮祖细胞(EPCs)与冠心病(CHD)危险因素及冠状动脉病变严重程度之间的相关性及其临床意义。

方法

研究42例冠心病患者和36例排除冠心病的患者(对照组)。通过Ficoll密度梯度离心法从外周血中分离出总单核细胞,并在补充有20%胎牛血清、50 ng/ml血管内皮生长因子(VEGF)的M199培养基中培养。培养14天后,用相差显微镜计数EPCs的集落形成单位数量。评估EPCs集落形成单位数量与冠心病危险因素(如年龄、性别、高血压、高胆固醇血症、糖尿病、吸烟、冠心病家族史阳性)以及冠状动脉病变严重程度之间的关系。

结果

冠心病危险因素数量与EPCs水平降低显著相关(r = -0.436,P = 0.014)。吸烟与EPCs水平显著降低相关,而在存在性别、高血压和冠心病家族史阳性的情况下,EPCs水平有轻微但不显著的降低。观察到低密度脂蛋白(LDL)和尿酸与循环EPCs的集落形成单位数量呈负相关(P < 0.05)。年龄、高密度脂蛋白、载脂蛋白A与循环EPCs水平之间存在相关性,然而,这种关系无统计学意义。冠心病组循环EPCs的集落形成单位数量显著低于对照组(12.8±6.34对37.±5.5,P < 0.001);冠状动脉病变组(包括单支、双支、三支血管病变)的循环EPCs水平显著低于对照组(P < 0.01)。

结论

循环EPCs水平与冠心病危险因素评分及冠状动脉病变严重程度呈负相关。这些发现表明,在缺乏足够循环EPCs的情况下,内皮损伤可能会影响心脏疾病的程度和临床状况。

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