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目的研究冠心病患者血清高敏C反应蛋白(hs-CRP)与循环内皮祖细胞(EPCs)水平之间的关系及临床意义。方法将46例研究对象随机分为稳定型心绞痛(SAP)组(n=18)、急性冠脉综合征(ACS)组(n=24)及对照组(n=36),并根据冠状动脉造影结果分为单支病变组(n=18)、双支病变组(n=14)及三支病变组(n=10)。胶乳凝集反应法测定冠状动脉造影患者高敏CRP浓度,同时采集研究对象外周血进行EPCs的分离培养,倒置相差显微镜下计数细胞克隆形成单位评估循环EPCs水平。结果ACS组hs-CRP浓度明显高于对照组和SAP组,而SAP组及ACS组循环EPCs水平明显低于对照组(P<0.05);双支病变组与三支病变组hs-CRP水平较对照组显著升高(P<0.05),冠状动脉病变(单支、双支、三支)组EPCs水平均显著低于对照组(P<0.01)。高敏C反应蛋白与循环内皮祖细胞水平呈负相关(r=-0.429,P<0.05)。结论CRP和EPCs与冠心病及冠状动脉病变程度具有相关性,且CRP和EPCs两者之间呈负相关。提示CRP可能通过抑制EPCs数量从而减弱EPCs参与损伤内皮修复的能力,与冠心病发生及临床表现相关。
Objective To study the relationship between serum hs-CRP and circulating endothelial progenitor cells (EPCs) in patients with coronary heart disease and its clinical significance. Methods Forty-six subjects were randomly divided into stable angina pectoris (SAP) group (n = 18), acute coronary syndrome group (n = 24) and control group (n = 36) The results were divided into single vessel disease group (n = 18), double vessel disease group (n = 14) and three vessel disease group (n = 10). The latex agglutination reaction method was used to measure the concentration of high-sensitivity CRP in patients with coronary artery angiography. At the same time, the peripheral blood of the subjects were collected to isolate and culture EPCs, and the EPCs levels were evaluated by inverted phase contrast microscope counting cell clone formation unit. Results The concentration of hs-CRP in ACS group was significantly higher than that in control group and SAP group. The levels of circulating EPCs in SAP group and SAP group were significantly lower than those in control group (P <0.05) (P <0.05). The levels of EPCs in coronary artery (single branch, double branch and triple branch) group were significantly lower than those in control group (P <0.01). High sensitivity C-reactive protein and circulating endothelial progenitor cells were negatively correlated (r = -0.429, P <0.05). Conclusion CRP and EPCs have a correlation with coronary heart disease and the degree of coronary artery disease, and there is a negative correlation between CRP and EPCs. These results suggest that CRP may be related to the occurrence of coronary heart disease and clinical manifestations by inhibiting the number of EPCs and thus decreasing the ability of EPCs to participate in the injury of endothelial repair.