心肌梗死患者其“罪犯”血管再通后CD34^+单核细胞的动员终止

作     者：Müller-Ehmsen J. Scheid C. Grundmann F. 孙凯 

作者机构：Laboratory of Muscle Research and Molecular Cardiology Department of Internal Medicine III University of Cologne Joseph-Stelzmann-Str. 24 50924 Kln Germany 

出 版 物：《世界核心医学期刊文摘（心脏病学分册）》 (Digest of the World Core Medical Journals(Cardiology))

年 卷 期：2005年第1卷第12期

页      面：39-40页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：血管再通 心肌再生 细胞计数 合并肺炎 流式细胞计量术 肺炎患者 缺血时间 造血干细胞 血管造影 活性细胞 

摘      要：Background: The mobilization of hematopoietic progenitor cells from bone marrow has been proposed to play a role in cardiac regeneration after myocardial infarction(MI). Accordingly, an increase in CD34 positive cells(CD34+) has been observed in the peripheral blood of patients after acute myocardial infarction. Here, we evaluated the influence of an acute percutaneous coronary intervention(PCI) of the occluded artery on the mobilization of CD34+in acute MI. Methods: CD34 positive cells were quantified by flow cytometry(FACS analysis) and expressed as number per million white blood cells. Peripheral blood was obtained and analyzed at day 5 after the onset of symptoms from patients with acute MI without early PCI(n=11, age 63±5 years), acute MI with rapid PCI(n=7, age 63±3), patients with pneumonia(n=5, age 51±6), patients without angiographical signs of coronary artery disease(control, n=5, age 66±8) and young healthy volunteers(n=11, age 28±1). Results: Patients with MI but without PCI had a higher CD34+count at day 5(312±48 per 106 leukocytes) than control(156±40, P=0.03) and MI with PCI(173±31, P=0.03). No increase in CD34+was observed in patients who underwent PCI vs. control. Patients with pneumonia had higher CD34+(350±44) than patients with MI with PCI(P=0.01) and control(P=0.01). Healthy individuals who were much younger than all other groups(28±1 years, P 0.0001 vs. all groups) had the highest CD34+(526±51, P=0.006 vs. MI without PCI, P=0.00003 vs. MI with PCI, P=0.02 vs. pneumonia, P=0.00006 vs. control). Conclusions: Shorter time of ischemia and reduced cell death may be the reasons for reduced CD34+cell count after acute MI with early percutaneous intervention vs. acute MI without intervention. Besides ischemia, also inflammation as present in pneumonia may cause a mobilization of CD34+cells. Age may be a major factor that influences the mobilization of CD34+cells and the regenerative capacity of the heart.