摘要
目的测定慢性阻塞性肺疾病急性加重期(AECOPD)患者外周血内皮祖细胞(EPC)数量,探讨其与患者疾病严重程度及心血管合并症的关系。方法收集2010年12月至2011年12月住院的40例COPD患者,其中急性加重期27例,稳定期13例;另选同期16例非吸烟健康受试者作为对照组。采用密度梯度离心法获取外周血单个核细胞,免疫磁珠分选法分离出CD34+细胞并计数,免疫比浊法检测血清高敏C反应蛋白(hsCRP)浓度,ELISA法测定基质金属蛋白酶9(MMP-9)浓度,同时测定肺功能(FEV1%pred、FEV1/FVC)及AECOPD患者的动脉血气、心脏彩超。分析EPC数量与hsCRP、MMP-9及气流受限程度、心血管功能评价指标之间的相关性。结果 AECOPD组及稳定期COPD组外周血EPC数量显著低于对照组[(5.1±2.6)×103/mL和(6.0±3.2)×103/mL比(9.0±4.3)×103/mL,P<0.05]。外周血EPC数量与hsCRP水平呈弱负相关,与MMP-9无明显相关性。AECOPD患者中,EPC数量与肺动脉收缩压(PASP)、外周血脑钠肽(NT-proBNP)水平呈显著负相关,与左室射血分数呈正相关(P均<0.05),与气流受限程度、血气分析、住院时间、吸烟指数无明显相关性(P均>0.05)。结论 AECOPD患者外周血EPC数量下降,可能受系统性炎症反应调节,可能参与COPD合并心血管疾病的发生和发展。
Objective To measure the level of circulating endothelial progenitor cells （EPCs） in peripheral blood of patients with acute exacerbation of chronic obstructive pulmonary disease （ AECOPD）, and to explore the relationship between EPCs and severity markers of the disease and cardiovascular adverse outcome predictors. Methods Forty patients with COPD were recruited, including 27 at acute exacerbation phase and 13 with stable COPD from December 2010 to December 2011. Sixteen healthy nonsmokers were included as controls. Circulating EPCs were isolated by Ficoll density-gradient centrifugation and purified by Magnetic Activated Cell Sorting system. High-sensitivity C-reactive protein （hsCRP） was estimated by using a latex immunoturbidimetric assay kit, and matrix metalloproteinase-9 （ MMP-9 ） was measured by enzyme- linked immunosorbent assay （ELISA）. Arterial blood gas analysis and echocardiograph were performed in the AECOPD patients. The correlations between circulating EPCs,lung function, and cardiovascular markers were investigated. Results Circulating EPCs were significantly lower in AECOPD and stable COPD patients compared with the healthy controls [（5.1±2.6）×103/mL and （6.0±3.2）×103/mL vs.（9.0±4.3）×103/mL,P〈0.05]. EPCs had a weak correlation with hsCRP （P= 0. 033 ）,but not with MMP-9. In the AECOPD patients, EPC counts were significantly inversely correlated with PASP （pulmonary artery systolic pressure） and NT-proBNP （amino-terminal pro-brain natriuretic peptide） levels, and positively with left ventricular ejection fraction. No correlations were found between EPCs and lung function, blood gas, hospital stays or smoking index. Conclusions Circulating EPCs were significantly lower in AECOPD patients compared with healthy controls, in which systemic inflammation might be involved. Decreased EPCs were correlated with cardiac dysfunction in patients with AECOPD, which may account for the increased cardiovascular risk in this population.
出处
《中国呼吸与危重监护杂志》
CAS
2013年第1期7-11,共5页
Chinese Journal of Respiratory and Critical Care Medicine
关键词
内皮祖细胞
慢性阻塞性肺疾病
高敏C反应蛋白
基质金属蛋白酶9
心血管疾病
Endothelial progenitor cells
Chronic obstructive pulmonary disease
High-sensitivity C-reactive protein
Matrix metalloproteinase-9
Cardiovascular disease
