【摘要】 目的:研究证实随着年龄的增长外周血干细胞动员效率呈下降趋势,急性心肌梗死老年患者是否存在这种下降趋势还不清楚。对比观察粒细胞集落刺激因子对老年与非老年急性心肌梗死患者外周血干细胞的动员效果。方法:①选择2004-03/2006-01辽宁省心血管病医院心血管内科收治的35例急性心肌梗死(≤30d)住院患者,男29例,女6例。按年龄分为两组:≥60岁为老年组,16例;<60岁为非老年组,19例。两组患者性别、体质量、急性心肌梗死发生时间等基线资料基本一致,对本实验均知情同意。②包涵体型粒细胞集落刺激因子,商品名:惠尔血,麒麟昆鹏生物制药有限公司生产,批号030551,300μg/支。③实验前两组患者均查白细胞计数和分类,以除外潜在血液系统恶性疾病的可能。患者入选后给予包涵体型粒细胞集落刺激因子,300～600μg/d一次性注射皮下注射,连续5d。分别在动员前和动员后第3,4,5,6,7天进行外周血中白细胞记数,将CD34+细胞视为干细胞,采用FACSCalibur流式细胞仪测定外周血中CD34+数量。结果:35例急性心肌梗死患者均全部进入结果分析。①两组患者粒细胞集落刺激因子动员前后外周血中白细胞数量的变化:两组动员前及动员后3,4,5,6,7d外周血中白细胞数量差异均无显著性意义(P=0.142,0.763,0.150,0.448,0.856,0.431),且动员高峰均出现在第5～6天。②两组患者粒细胞集落刺激因子动员后不同时间点外周血中CD34+细胞数量的变化:两组动员前及动员后3,4,5,6,7d外周血中CD34+细胞数量差异均无显著性意义(P=0.122,0.093,0.075,0.056,0.244),且动员高峰均出现在第5～6天。③外周血中白细胞数量与CD34+细胞数量相关性分析:两组外周血中白细胞数量与CD34+细胞数量均呈正相关,老年组r=0.89,非老年组r=0.69。结论:老年与非老年急性心肌梗死患者外周血干细胞经粒细胞集落刺激因子动员后,二者外周血中白细胞数量与CD34+数量均基本相似。白细胞数量与CD34+数量呈正相关,且变化曲线高峰出现在动员后第5天或第6天。更多还原

【Abstract】 AIM: Research verified that the mobilization effect of peripheral blood stem cells was decreased with the increase of age. It is unclear that whether this kind of decrease occurs in the old patients with acute myocardial infarction (AMI). To comparatively observe the mobilization effects of granulocyte colony-stimulating factor (G-CSF) on peripheral blood stem cells between old and non-old patients with AMI. METHODS: ①Totally 35 inpatients with AMI (≤ 30 d) were selected from Department of Cardiology, Liaoning Cardiovascular Disease Hospital between March 2004 and January 2006, including 29 males and 6 females. They were divided into two groups according to age: ≥ 60 years as old age-group (n =16) and < 60 years as non-old age-group (n = 19). Sex, body mass and the onset time of AMI of patients in the two groups were similar. The patients all knew the fact and agreed to participate into the trial. ②Inclusive type G-CSF, trade name: filgrastim, produced by Qilin Kunpeng Biological Pharmacy Co., Ltd., lot number 030551, 300 μg each. ③Leukocytes were counted and classified in the two groups before experiment to exclude the existence of malignancy disease in hematological system. The patients received inclusive type G-CSF with the dose of 300-600 μg/day by hypodermical injection, for successively 5 days. Leucocytes in peripheral blood were counted before mobilization and at days 3, 4, 5, 6 and 7 after mobilization, respectively. CD34+ cells were considered as stem cells. CD34+ cells in the peripheral blood were counted by FACS Calibur flow cytometer. RESULTS: A total of 35 AMI patients were involved in the result analysis. ①change of leucocyte quantity in peripheral blood before and after G-CSF mobilization in the two groups: There was no significant difference of leucocyte quantity in peripheral blood before and after mobilization in the two groups at days 3, 4, 5, 6 and 7 (P = 0.142,0.763,0.150,0.448,0.856,0.431). Mobilization reached the peak at days 5 and 6. ②change of CD34+ cell quantity in the peripheral blood at different time points after G-CSF mobilization in the two groups: There was no significant difference of CD34+ cell quantity in the peripheral blood at days 3, 4, 5, 6 and 7 before and after mobilization in the two groups (P =0.122,0.093,0.075,0.056,0.244). Mobilization reached the peak at days 5 and 6. ③correlation between leucocyte and CD34+ cell quantity in peripheral blood: The leucocyte quantity was positively correlated with CD34+ cell quantity in the peripheral blood of the two groups, r = 0.89 in the old age-group and r = 0.69 in the non-old age-group. CONCLUSION: Leucocyte quantity and CD34+ cell quantity in the peripheral blood are similar between the old and non-old patients with AMI after G-CSF mobilization. The leucocyte quantity is positively correlated with CD34+ cell quantity, and the mobilized peak of leucocytes and CD34+ cells appears at days 5 and 6 after mobilization.更多还原