循环内皮细胞与冠状动脉疾病。
Circulating endothelial cells in coronary artery disease.
机构信息
Department of Pathobiochemistry and Clinical Chemistry, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland.
出版信息
Kardiol Pol. 2010 Oct;68(10):1100-5.
BACKGROUND
endothelial damage and dysfunction play a crucial role in the pathophysiology of coronary artery disease (CAD). The quantification of circulating endothelial cells (CEC) in the peripheral blood is a novel method for assessing endothelial damage.
AIM
to evaluate the possible diagnostic use of single quantification of CEC in peripheral blood by flow cytometry in patients with CAD.
METHODS
we examined 48 patients with CAD, including 23 patients with acute myocardial infarction (AMI) and 25 patients with stable angina (SA). The control group consisted of 20 healthy subjects without symptoms of CAD. The CEC count was evaluated by flow cytometry using antibodies against CD31, CD146, and CD45. Plasma biochemical markers of endothelial damage (von Willebrand Factor [vWF], thrombomodulin [TM]) were measured by ELISA. Serum concentrations of troponin I (TnI) and lipid parameters were also included in the statistical analysis.
RESULTS
A significant increase in the CEC count was found in patients with AMI compared to the control group (p < 0.05) and SA patients (p < 0.05). However, no difference was found in the CEC count between patients with SA and the control group. Increased vWF activity was found in both groups of CAD patients compared to the control group (AMI: p < 0.001, SA: p , 0.01), and vWF activity was significantly higher in AMI patients compared to SA patients (p < 0.001). Thrombomodulin concentration did not differ significantly between any patient groups and the control group. The CEC count correlated positively with vWF activity (r = 0.3852, p < 0.05) and the atherogenic index TC/HDL-C (r = 0.3844, p < 0.05) in all patients with CAD (AMI + SA). The sensitivity of CEC count for the diagnosis of an acute coronary syndrome was lower than that of TnI level on admission (39% vs 69%).
CONCLUSIONS
we confirmed that CEC count in peripheral blood can be determined by flow cytometry in CAD patients with both AMI and SA. The CEC count in AMI was increased in comparison to healthy subjects and SA patients in one third of all cases. To determine whether CEC count could be used to improve the diagnosis of an acute coronary syndrome in patients with CAD, additional studies in larger patient groups would be required.
背景
内皮损伤和功能障碍在冠状动脉疾病（CAD）的病理生理学中起着关键作用。外周血循环内皮细胞（CEC）的定量是评估内皮损伤的一种新方法。
目的
评估通过流式细胞术对 CAD 患者外周血中单次 CEC 定量的可能诊断用途。
方法
我们检查了 48 例 CAD 患者，包括 23 例急性心肌梗死（AMI）患者和 25 例稳定型心绞痛（SA）患者。对照组由 20 名无 CAD 症状的健康受试者组成。使用针对 CD31、CD146 和 CD45 的抗体通过流式细胞术评估 CEC 计数。通过 ELISA 测量内皮损伤的血浆生化标志物（血管性血友病因子[vWF]、血栓调节蛋白[TM]）。还将肌钙蛋白 I（TnI）和脂质参数的血清浓度纳入统计分析。
结果
与对照组相比，AMI 患者的 CEC 计数显着增加（p < 0.05），与 SA 患者相比（p < 0.05）。然而，SA 患者和对照组之间的 CEC 计数没有差异。与对照组相比，两组 CAD 患者的 vWF 活性均升高（AMI：p < 0.001，SA：p < 0.01），AMI 患者的 vWF 活性明显高于 SA 患者（p < 0.001）。TM 浓度在任何患者组与对照组之间均无显着差异。CEC 计数与 vWF 活性（r = 0.3852，p < 0.05）和致动脉粥样硬化指数 TC/HDL-C（r = 0.3844，p < 0.05）在所有 CAD 患者（AMI + SA）中呈正相关。CEC 计数对诊断急性冠状动脉综合征的敏感性低于入院时 TnI 水平（39%对 69%）。
结论
我们证实，通过流式细胞术可以在患有 AMI 和 SA 的 CAD 患者中确定外周血中的 CEC 计数。与健康受试者和 SA 患者相比，AMI 患者中三分之一的 CEC 计数增加。为了确定 CEC 计数是否可用于改善 CAD 患者急性冠状动脉综合征的诊断，需要在更大的患者群体中进行进一步的研究。
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