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目的：研究冠状动脉严重狭窄稳定型心绞痛(Stable angina pectoris, SPA)患者循环内皮祖细胞（endothelial progenitor cells， EPCs）及基质细胞衍生因子（SDF）-1-alpha与冠状动脉侧支循环（CCC）形成的相关性，以期为治疗冠心病提供新的思路。方法：选择 2012 年8 月到2014 年12月在我院就诊的88 例冠状动脉严重狭窄的稳定型心绞痛患者（CCC 良好40 例、不良48 例），均采集外周血测定EPC 数量、体外生成血管能力，并用ELISA 法检测其血浆SDF-1alpha 水平，采用直线相关和Pearson 检验分析CCC良好与不良者各指标间及与CCC 分级的相关性；将所有入选病例随机分为6 组，并分离外周血单个核细胞并分别加入不同的培养液，培养7 天后体外测定EPCs 数量以及生成血管的能力，并通过ELISA 法检测培养液上清中VEGF 的蛋白水平。结果：CCC 不良组EPCs 数量、体外生成血管能力及SDF-1-alpha水平均明显低于CCC 良好组（P<0.05）。体外生成血管能力、循环EPCs 数量以及 SDF-1alpha水平均与CCC分级呈现显著的正相关性（r =0.72、0.67、0.79，均P<0.05）；循环EPCs 数量、SDF-1alpha水平以及体外生成血管能力亦均呈现显著正相关性（r =0.78、0.62，均P<0.05）。与PBS、SDF-1alpha+ AMD3100 及SDF-1alpha+ KI8751 干预物质比较，SDF-1琢能够呈剂量依赖性的明显提高EPCs 数量、增强其体外生成血管的能力及VEGF水平（P<0.05）。结论：冠状动脉严重狭窄稳定型心绞痛患者循环EPCs及SDF-1琢与CCC 形成有关，VEGF可能参与该过程。

英文摘要:

Objective:To study the correlation between coronary collateral circulation (CCC) and endothelial progenitor cells (EPCs), stromal cell derived factor-1alpha(SDF-1alpha) in stable angina pectoris (SAP) patients with serious coronary stenosis, and to provide new thread to coronary artery disease.Methods:88 SAP patients with serious coronary artery stenosis of August 2012 to December 2014 in our hospital were selected, in which 40 patients with well CCC and 48 patients with poor CCC. EPCs were isolated from peripheral blood samples, then its colonies were counted and vascular genesis capacity in vitro was assayed respectively. The plasma level of SDF-1alpha was determined by ELISA. Rectilinear correlation and Pearson analysis were adopted to analyze the correlation of above indexes and CCC classification. MNC were isolated from peripheral blood samples of 88 patients. All selected cases randomly divided into 6 groups and then isolated peripheral blood mononuclear cells with addition of different culture solution. EPC colonies were counted and vascular genesis capacity were assayed respectively, and vascular endothelial growth factors from the culture medium were also measured In vitro ELISA after 7 days of cultivation.Results:CCC well group exhibited an increased number of colony-forming units (CFUs), vascular genesis in vitro and level of SDF-1alpha, compared with CCC poor group. There was Significant positive correlation between the 3 indexes and the classification of CCC(P<0.05). Compared with groups of PBS, SDF-1alpha+AMD3100, SDF-1alpha+KI8751, the number of CFUs and vascular genesis capacity in vitro of cultured EPCs, concentration of VEGF in the culture medium were increased with a dose-dependent manner by SDF-1alpha(P<0.05).Conclusion:The development of CCC in SAP patients with serious coronary artery stenosis is correlated with EPCs and the level of SDF-1alpha, and this procedure maybe regulated by VEGF.

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