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。%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.
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