摘要
目的：观察重组人脑利钠肽（ rhBNP）对急性ST段抬高型心肌梗死（ STEMI）患者外周血内皮祖细胞（ EPCs）数量及功能的影响，并评估对冠状动脉侧枝循环形成及心功能的影响。方法选择海南省人民医院心内科未行急诊血运重建治疗（梗死时间＞12 h）的STEMI患者132例，随机分成两组，第一组为静脉使用rhBNP组70例，第二组为未使用rhBNP的对照组62例，分别在发病第1、7天抽取外周血，采用贴壁选择法培养人外周血EPCs，荧光显微镜鉴定EPCs，并检测EPCs数量及体外增殖、迁移、黏附、体外血管生成能力。发病第7天行冠状动脉造影并使用Rentrop侧枝循环分级法评估侧枝循环形成，并心脏彩超测量LVDD、LVEF及检测血浆BNP来评估心功能。结果与对照组比较，rhBNP组外周血EPCs的数量明显增加，EPCs增殖、迁移、黏附、体外血管生成能力明显改善（P＜0．01），冠状动脉侧枝循环明显丰富，心功能明显改善（P＜0．05）。结论 rhBNP明显改善STEMI患者EPCs功能，促进冠状动脉侧枝循环的形成，改善心功能。
Objective To study the efficiency of recombinant human brain natriuretic peptide （ rhBNP） on peripheral vascular endothelial progenitor cells （ EPCs ） and to investigate the effect on coronary collateral circulation and cardiac function in acute ST segment elevation myocardial infarction （ STEMI ） .Methods One hundred and thirty -two STEMI patients of Hainan Province People＆#39;s Hospital who did not underwent emergency reascularization surgery, were randomly divided into rhBNP group （n=70） and the control group （n=62）.After 7 days of rhBNP intravenous injection, EPCs were isolated from human peripheral blood by ficoll density gradient centrifugation and cultured. Some methods were adopted to observe the numbers, proliferation, adhesion, migration and angiogenesis of EPCs.Then, coronary angiography was taken and Rentrop collateral circulation grading method was used to evaluate density of side branch vessels.LVDD, LVEF and BNP were detected to estimate cardiac function.Results Compared with control, the number of peripheral blood EPCs of rhBNP group increased significantly （ P 〈0.01 ）.The ability of the proliferation, adhesion, migration, and angiogenesis of the EPCs was improved significantly （P〈0.01）.The density of side branch vessels and cardiac function were improved obviously （P〈0.05）.Conclusion rhBNP can significantly improve the function of EPCs in STEMI patients, promote the formation of coronary collateral circulation and improve cardiac function.
出处
《中国急救医学》
CAS
CSCD
北大核心
2015年第3期243-247,290,共6页
Chinese Journal of Critical Care Medicine
