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目的:研究冠状动脉严重狭窄稳定型心绞痛(Stable angina pectoris,SPA)患者循环内皮祖细胞(endothelial progenitor cells,EPCs)及基质细胞衍生因子(SDF)-1α与冠状动脉侧支循环(CCC)形成的相关性,以期为治疗冠心病提供新的思路。方法:选择2012年8月到2014年12月在我院就诊的88例冠状动脉严重狭窄的稳定型心绞痛患者(CCC良好40例、不良48例),均采集外周血测定EPC数量、体外生成血管能力,并用ELISA法检测其血浆SDF-1α水平,采用直线相关和Pearson检验分析CCC良好与不良者各指标间及与CCC分级的相关性;将所有入选病例随机分为6组,并分离外周血单个核细胞并分别加入不同的培养液,培养7天后体外测定EPCs数量以及生成血管的能力,并通过ELISA法检测培养液上清中VEGF的蛋白水平。结果:CCC不良组EPCs数量、体外生成血管能力及SDF-1α水平均明显低于CCC良好组(P<0.05)。体外生成血管能力、循环EPCs数量以及SDF-1α水平均与CCC分级呈现显著的正相关性(r=0.72、0.67、0.79,均P<0.05);循环EPCs数量、SDF-1α水平以及体外生成血管能力亦均呈现显著正相关性(r=0.78、0.62,均P<0.05)。与PBS、SDF-1α+AMD3100及SDF-1α+KI8751干预物质比较,SDF-1α能够呈剂量依赖性的明显提高EPCs数量、增强其体外生成血管的能力及VEGF水平(P<0.05)。结论:冠状动脉严重狭窄稳定型心绞痛患者循环EPCs及SDF-1α与CCC形成有关,VEGF可能参与该过程。
Objective: To investigate the effects of endothelial progenitor cells (EPCs), stromal cell-derived factor (SDF) -1α and coronary collateral circulation (CCC) in patients with severe coronary artery stenosis and stable angina pectoris (Stable angina pectoris) Relevance, in order to provide new ideas for the treatment of coronary heart disease. Methods: From August 2012 to December 2014, 88 patients with severe angina of severe coronary artery stenosis (40 cases of CCC and 48 cases of poor) were enrolled in our hospital from August 2012 to December 2014. All the peripheral blood samples were collected to determine the number of EPCs and the in vitro angiogenesis Ability and the level of plasma SDF-1αwere detected by ELISA. The correlation between CCC grade and CCC grade was analyzed by linear correlation and Pearson test. All selected cases were randomly divided into 6 groups, and the peripheral blood was separated Mononuclear cells were added to different culture medium. After 7 days of culture, the number of EPCs and the ability to produce blood vessels were measured in vitro. The protein level of VEGF in culture supernatant was detected by ELISA. Results: The number of EPCs, the ability of angiogenesis in vitro and the level of SDF-1α in CCC poor group were significantly lower than those in CCC good group (P <0.05). The number of circulating EPCs, the number of circulating EPCs and the level of SDF-1α were positively correlated with the CCC grade (r = 0.72,0.67,0.79, all P <0.05). The number of circulating EPCs, the level of SDF-1α and the in vitro angiogenesis Ability also showed a significant positive correlation (r = 0.78,0.62, all P <0.05). Compared with PBS, SDF-1α + AMD3100 and SDF-1α + KI8751 interventions, SDF-1α significantly increased the number of EPCs in a dose-dependent manner and enhanced the ability of angiogenesis and VEGF in vitro (P <0.05). CONCLUSION: Circulating EPCs and SDF-1α are involved in the formation of CCC in patients with severe coronary artery stenosis. VEGF may be involved in this process.