Kunz Geoffrey A, Liang Ge, Cuculi Florim, Gregg David, Vata Korkut C, Shaw Linda K, Goldschmidt-Clermont Pascal J, Dong Chunming, Taylor Doris A, Peterson Eric D
Duke University Medical Center, Durham, NC 27710, USA.
Am Heart J. 2006 Jul;152(1):190-5. doi: 10.1016/j.ahj.2006.02.001.
Circulating endothelial progenitor cells (EPCs) may play an important role in the body's defense against atherosclerosis. Previous studies have shown an association between EPC numbers and the presence of traditional coronary artery disease (CAD) risk factors. The relationship between EPC numbers and the severity of atherosclerosis is, however, not known.
EPC counts were measured by quantitative cell culture in 122 patients undergoing diagnostic cardiac catheterization. The association between patients' EPC count and the presence of multivessel CAD and traditional cardiac risk factors was assessed using logistic regression analysis.
The median age of the study population was 58 years; 37% had multivessel CAD, 29% had diabetes, and 14% had myocardial infarction this admission. EPC counts did not vary significantly with most established cardiac risk factors but were lower in diabetics versus nondiabetics and trended toward lower numbers in older patients. EPC count was the second strongest predictor of multivessel CAD, after patient age. Patients with multivessel disease had significantly lower EPC counts than those without (median, 3 vs 13; P < .0088). For every 10 colony forming unit increase in EPCs, a patient's likelihood for multivessel CAD declined by 20% (P < .001).
This study demonstrates an inverse relationship between circulating EPCs and CAD severity, independent of traditional risk factors. If confirmed in ongoing studies, this may represent an important new diagnostic and therapeutic target for coronary disease treatment.
循环内皮祖细胞（EPCs）可能在机体抵御动脉粥样硬化中发挥重要作用。既往研究显示EPC数量与传统冠状动脉疾病（CAD）危险因素的存在之间存在关联。然而，EPC数量与动脉粥样硬化严重程度之间的关系尚不清楚。
通过定量细胞培养对122例接受诊断性心导管检查的患者进行EPC计数。使用逻辑回归分析评估患者EPC计数与多支血管CAD及传统心脏危险因素存在之间的关联。
研究人群的中位年龄为58岁；37%患有多支血管CAD，29%患有糖尿病，本次入院时14%患有心肌梗死。EPC计数与大多数已确定的心脏危险因素无显著差异，但糖尿病患者的EPC计数低于非糖尿病患者，且老年患者的EPC计数有降低趋势。EPC计数是多支血管CAD的第二强预测因素，仅次于患者年龄。患有多支血管疾病的患者的EPC计数显著低于无多支血管疾病的患者（中位数分别为3和13；P < 0.0088）。EPC每增加10个集落形成单位，患者患多支血管CAD的可能性下降20%（P < 0.001）。
本研究表明循环EPCs与CAD严重程度呈负相关，且独立于传统危险因素。如果在正在进行的研究中得到证实，这可能代表冠心病治疗的一个重要新诊断和治疗靶点。
