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目的:观察急性心肌梗死(AMI)时外周血细胞间黏附分子-1(ICAM-1)、干细胞的变化以及两者之间的关系。方法:①AMI患者共15例,收集AMI患者入院即刻、1、3、7、14和28d的抗凝血2ml,用ELISA法检测各时间点血清ICAM-1的水平,同时用流式细胞仪检测干细胞表面标志物CD34,比较各时间点的差别以及分析ICAM-1与干细胞间可能存在的关系。②开胸结扎16只大鼠左前降支近端,制作AMI模型,对照组和实验组各8只,实验组从尾静脉注入ICAM-1受体拮抗剂。分别在术后1、3、7和14d抽取大鼠尾静脉血用流式细胞法检测其外周血中CD34+细胞数量,用ELISA方法检测血清中ICAM-1浓度变化,比较各时间点2组CD34+细胞数量的差别。结果:AMI后CD34阳性细胞逐渐升高,到第7天时达到峰值(P<0.05)。AMI患者外周血清ICAM-1变化呈波浪型,在AMI即刻均达到高峰,以后随着时间推移缓慢下降再逐渐上升。相关分析显示CD34阳性细胞与外周血ICAM-1在AMI后第1天与第3天呈线性相关。动物实验方面:给予ICAM-1受体拮抗剂后的实验组大鼠与对照组相比,其外周血CD34流式细胞结果在各时间点均有所上升,AMI7d时最明显[(12±2.11)%︰(3.14±0.55)%P<0.05]。结论:AMI可上调外周血干细胞数量,同时血清中ICAM-1也会上升,但ICAM-1抑制了AMI后外周血成体干细胞的上调。
Objective: To observe the changes of peripheral blood intercellular adhesion molecule-1 (ICAM-1), stem cells and the relationship between them in acute myocardial infarction (AMI). Methods: ①A total of 15 patients with AMI were collected. The anticoagulant blood samples of AMI patients were collected at 1, 3, 7, 14 and 28 days immediately after admission. The levels of ICAM-1 in serum were detected by ELISA at the same time. Flow cytometry Stem cell surface marker CD34 was used to compare the different time points and to analyze the possible relationship between ICAM-1 and stem cells. ② Thoracotomy was performed to ligate the proximal left anterior descending artery of 16 rats to make AMI model. The control group and experimental group were each 8 rats in each group. The experimental group was injected ICAM-1 receptor antagonist from the tail vein. The number of CD34 + cells in peripheral blood was measured by flow cytometry at 1, 3, 7 and 14 days after operation respectively. The concentration of ICAM-1 in serum was detected by ELISA. Two groups of CD34 + The difference in the number of cells. Results: CD34 positive cells increased gradually after AMI and peaked on the 7th day (P <0.05). The changes of ICAM-1 in peripheral serum of AMI patients showed a wave pattern, which peaked immediately at AMI, then decreased slowly and then increased gradually with the passage of time. Correlation analysis showed that there was a linear correlation between CD34 positive cells and ICAM-1 in peripheral blood on day 1 and day 3 after AMI. Animal experiments: Compared with the control group, the results of CD34 flow cytometry in peripheral blood of experimental rats after ICAM-1 receptor antagonist administration increased at each time point, the most obvious was on AMI7 [(12 ± 2.11 )%: (3.14 ± 0.55)% P <0.05]. Conclusion: AMI can up-regulate the number of peripheral blood stem cells and increase the level of ICAM-1 in serum. However, ICAM-1 inhibits the up-regulation of peripheral blood adult stem cells after AMI.