中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (23): 4355-4358.doi: 10.3969/j.issn.1673-8225.2011.23.040

• 干细胞临床实践 clinical practice of stem cells • 上一篇    下一篇

急性心肌梗死患者外周血CD34+细胞与肌酸激酶同工酶、N末端B型利钠肽原、左室射血分数的相关性

高海英1，曲  鹏2   

  1. 大连医科大学附属二院，1综合一病房，2心内科，辽宁省大连市116027
  • 收稿日期:2011-02-25 修回日期:2011-03-27 出版日期:2011-06-04 发布日期:2011-06-04
  • 作者简介:高海英★，女，1977年生，辽宁省沈阳市人，汉族，2005年大连医科大学毕业，硕士，主治医师，主要从事冠状动脉粥样硬化性心脏病综合诊治方面的研究。 gaohaiying77@yahoo.com.cn

Correlation of peripheral blood CD34-positive cells with creatine kinase MB, N-terminal pro-B-type natriuretic peptide, and left ventricular ejection fraction in patients with acute myocardial infarction

Gao Hai-ying1, Qu Peng2   

  1. 1Department of Internal Medicine, 2Department of Cardiology, the Second Affiliated Hospital of Dalian Medical University, Dalian  116027, Liaoning Province, China
  • Received:2011-02-25 Revised:2011-03-27 Online:2011-06-04 Published:2011-06-04
  • About author:Gao Hai-ying★, Master, Attending physician, Department of Internal Medicine, the Second Affiliated Hospital of Dalian Medical University, Dalian 116027,Liaoning Province, China Gaohaiying77@yahoo.com.cn

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被引次数

1

摘要：

背景：急性心肌梗死后具有动员骨髓和外周血中的CD34+干细胞的潜能，参与坏死心肌的自身修复，但外周血CD34+细胞与其他相关指标的关系尚不明确，
目的：观察急性心肌梗死患者外周血单个核CD34+细胞的动态变化规律，并进一步分析其与肌酸激酶同工酶、N末端B型利钠肽原、左室射血分数的相关性。
方法：采集急性心肌梗死患者(实验组)发病第2，3，4，5，7，30，90，120天的外周静脉血及入院后相应时间点非冠状动脉粥样硬化性心脏病患者(对照组)外周静脉血，采用流式细胞仪测定外周血单个核细胞CD34+的百分率。同时对心肌梗死患者进行肌酸激酶同工酶、N末端B型利钠肽原及心脏超声检测。
结果与结论：①实验组单个核细胞CD34+细胞百分率于心肌梗死后第3天开始升高，第4天达到高峰，第90天回降至基线水平。对照组单个核细胞CD34+细胞百分率无明显变化。②实验组外周血单个核CD34+细胞与左室射血分数呈正相关关系，与N末端B型利钠肽原呈负相关关系；与肌酸激酶同工酶无相关性。提示急性心肌梗死后4~8 d内给予干细胞治疗可适度改善心脏收缩功能，并且较高的CD34+干细胞表达有益于急性心肌梗死后心肌功能的恢复。

关键词: 急性心肌梗死, 外周血CD34+细胞, 肌酸激酶同工酶, 左室射血分数, N末端B型利钠肽原

Abstract:

BACKGROUND: Some studies had showed the potential of self-mobilization of CD34 positive stem cells in peripheral blood after acute myocardial infarction. Population remain poorly known about the correlation between the number of CD34 positive stem cells mobilized into peripheral blood, left ventricular ejection fraction (LVEF), N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, and myocardial necrosis markers in patients with acute myocardial infarction (AMI).
OBJECTIVE: To assess the spontaneous expression of CD34-positive cells after AMI and its relation to creatine kinase MB (CK-MB), NT-proBNP and LVEF. 
METHODS: The CD34-positive mononuclear cells in the peripheral blood of experimental patients were measured on days 2, 3, 4, 5, 7, 30, 90 and 120 after onset of AMI by flow cytometry. At the corresponding time the venous blood of control group, non-coronary heart disease people, also were collected. In experimental group, their myocardiac enzyme and cardiac troponin I were detected and NT-proBNP and echocardiography (UCG) were recorded.
RESULTS AND CONCLUSION: ①Flow cytometry revealed that percentage of peripheral blood CD34-positive mononuclear cells significantly increased on day 3 after AMI onset, reaching the peak level on day 4 and decreased gradually to the base line on day 90. ②The CD34-positive mononuclear cell was positively correlated with the LVEF levels and negatively correlated with NT-proBNP levels. The findings indicated that AMI is followed by enhanced spontaneous mobilization of CD34-positive cells. The peripheral blood CD34-positive mononuclear cells may improve cardiac function of ischemic heart disease and reduce the incidence rate of heart failure after AMI.

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