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目的探讨急性心肌梗死患者(AMI)外周循环中内皮祖细胞(EPCs)数目和内皮生长因子(VEGF)水平的变化意义。方法入选35例心肌梗死患者(实验组)和30例健康人(对照组),分别在AMI患者入院时以及治疗两周后采血,用密度梯度离心法获得单个核细胞(MNCs),用CD34、VEGF和AC133标定EPCs,用流式细胞仪(FCM)检测外周血中EPCs细胞数目,并用酶联免疫吸附试验(ELISA)检测患者血清中VEGF水平以及高敏C反应蛋白水平(hs-CRP)。结果 AMI患者入院时EPC数目以及血清中VEGF以及CRP水平明显高于对照组(p<0.05),在治疗两周后患者外周血中EPCs和VEGF仍高于正常水平(p<0.05),但是CRP已经恢复到正常水平。入院时患者EPCs数目和患者血清中hs-CRP水平呈正相关(r=0.5898,p=0.002);治疗两周后EPCs数目和患者血清中VEGF水平相关性(r=0.5915,p=0.0002)。结论 AMI患者早期循环中EPCs数量增加可能与急性炎症反应有关,而两周后EPC的数目增加可能VEGF对EPCs的动员有关,均有利于心梗部位的修复。
Objective To investigate the changes of the number of endothelial progenitor cells (EPCs) and the level of vascular endothelial growth factor (VEGF) in peripheral blood of patients with acute myocardial infarction (AMI). Methods 35 patients with myocardial infarction (experimental group) and 30 healthy people (control group) were enrolled in this study. Blood samples were taken at admission and two weeks after AMI. Mononuclear cells (MNCs) were obtained by density gradient centrifugation. CD34, EPCs were labeled with VEGF and AC133. The number of EPCs in peripheral blood was detected by flow cytometry (FCM). The levels of VEGF and hs-CRP in serum were detected by enzyme-linked immunosorbent assay (ELISA). Results The number of EPCs and serum levels of VEGF and CRP in AMI patients were significantly higher than those in control group (p <0.05). EPCs and VEGF levels in peripheral blood of patients with AMI were still higher than normal (p <0.05) two weeks after treatment, but CRP Has returned to normal levels. There was a positive correlation between the number of EPCs on admission and hs-CRP level in patients (r = 0.5898, p = 0.002). There was a significant correlation between the number of EPCs and serum VEGF levels two weeks after treatment (r = 0.5915, p = 0.0002). Conclusions The increased number of EPCs in early circulation of AMI may be related to acute inflammatory response. However, the increased number of EPC after two weeks may be related to the mobilization of EPCs, which is beneficial to the repair of myocardial infarction.