南方医科大学学报

南方医科大学学报 ›› 2014, Vol. 34 ›› Issue (11): 1574-.

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冠状动脉旁路移植术患者循环造血祖细胞的变化

张林，高长青，王嵘，肖苍松，吴扬   

  • 出版日期:2014-11-20 发布日期:2014-11-20

Changes of circulating hematopoietic progenitor cells in patients undergoing coronary
artery bypass graft surgery

  • Online:2014-11-20 Published:2014-11-20

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摘要： 目的评价冠心病患者冠状动脉旁路移植术对循环造血祖细胞的影响。方法前瞻性选择单纯行冠状动脉旁路移植术患
者51例，于术前、术后第1、3、5天采集患者外周静脉血，应用流式细胞仪分析CD34、CD133、CD45抗原，并应用集落形成试验和
迁移试验离体评价循环祖细胞的功能。结果无论是体外还是非体外冠状动脉旁路移植术，术后循环CD34+CD45dim细胞水平
（1.51±1.26 vs 2.02±1.16, P=0.036）及CD133+CD45dim祖细胞水平（1.16±0.85 vs 1.65±0.99, P=0.008）均较术前升高；体外循环
和非体外循环术后循环造血祖细胞水平和功能无显著差异，而体外循环手术后循环CD34+CD45dim 细胞变化（0.32±0.85 vs
0.86±0.68, P=0.04）及循环CD133+CD45dim细胞变化（0.63±0.57 vs 0.13±0.96, P=0.027）较非体外循环术后患者循环祖细胞水
平变化大。结论冠状动脉旁路移植术患者术后早期循环造血祖细胞水平升高，但逐渐降至正常水平。

Abstract: Objective To evaluate the changes of circulating hematopoietic progenitor cells (cHPCs) in patients undergoing
coronary artery bypass graft (CABG) surgery. Methods Fifty-one patients scheduled to undergo elective CABG surgery were
prospectively enrolled in this study. Blood samples were collected at baseline and at 1, 3, and 5 days after the surgery. CD34+
CD45dim，CD133 +CD45dim, and CD34 +CD133 + CD45dim cells were measured by flow cytometry. The functionality of the
circulating progenitor cells were studied in vitro using clonogenic and migration assays. Results All the elective patients
showed a significant postoperative increase of CD34 +CD45dim (1.51 ± 1.26 vs 2.02 ± 1.16, P=0.036) and CD133 +CD45dim cells
(1.16 ± 0.85 vs 1.65 ± 0.99, P=0.008) irrespective of on-pump or off-pump CABG. The perioperative changes of the cHPCs was
more significant in patients undergoing on-pump surgery than those having off-pump surgery. Conclusion In patients
undergoing elective cardiac surgery, cHPC level increased early after the surgery but recovers the normal level over time.