文章摘要
丁志坚,张宇燕,张馥敏,杨志健,王 新,徐龙保,王 健,陈解中,孙 勇,徐宇红.心肌梗死患者自体骨髓干细胞移植后近、中期心肌代谢及收缩功能的变化[J].南京医科大学学报,2006,(11):1086~
心肌梗死患者自体骨髓干细胞移植后近、中期心肌代谢及收缩功能的变化
Impact of autologous mononuclear bone marrow cells transplantation on early and med-term outcomes of the cardiac function and myocardial metabolism in patients with myocardial infaction
投稿时间:2006-05-19  
DOI:10.7655
中文关键词: 骨髓干细胞  细胞移植  心肌梗死
英文关键词: bone marrow stem cell  coronary heart disease  myocardial infarction
基金项目:常州市科技基金资助(CS2004208)
作者单位
丁志坚 南京医科大学附属常州二院心内科江苏 常州 213003 
张宇燕 南京医科大学附属常州二院心内科江苏 常州 213003 
张馥敏 南京医科大学第一附属医院心内科江苏 南京 210029 
杨志健 南京医科大学第一附属医院心内科江苏 南京 210029 
王 新 南京医科大学附属常州二院心内科江苏 常州 213003 
徐龙保 南京医科大学附属常州二院心内科江苏 常州 213003 
王 健 南京医科大学附属常州二院心内科江苏 常州 213003 
陈解中 南京医科大学附属常州二院心内科江苏 常州 213003 
孙 勇 南京医科大学附属常州二院心内科江苏 常州 213003 
徐宇红 南京医科大学附属常州二院心内科江苏 常州 213003 
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中文摘要:
      目的: 研究自体骨髓间充质干细胞(BMSCs)和单个核细胞(BMMNCs)经梗死相关冠状动脉(冠脉)移植对冠心病、心肌梗死患者近、中期心功能、心肌存活的影响及其安全性。方法:本项前瞻性、非随机、对照研究入选14例冠心病伴心肌梗死患者(其中8例患者为细胞治疗组,6例为常规治疗组)。细胞移植组患者,通过冠脉转运将BMSCs和BMMNCs植入心肌梗死区。两组患者均于术前和术后3、8个月分别行双核素SPECT心肌显像、二维超声心动图、6 min步行试验及动态心电图检查。结果:移植组患者在梗死相关冠脉开通后注入干细胞,8例心功能从Ⅱ~Ⅳ级提高至Ⅰ~Ⅱ级,6 min步行试验从320.72 ± 60.47 m提高至(406.88 ± 68.31)m,6个月后又提高至(484.79 ± 81.00)m。6例前壁心梗患者3、8个月后 LVEF由术前的42.5%提高至49.5%和54.0%;心肌双核素检查缺损区占整个心肌体积术后3、8个月由术前的45.5%减少至39.0%和25.0%。6例对照组患者术后3个月EF较术前提高,心肌双核素检查缺损区占心肌体积减少,术后8个月与术后3个月无明显改变。2例下壁心肌梗死患者经干细胞移植临床效果不明显。结论:自体BMSCs和MMNCs经冠脉移植治疗冠心病心肌梗死,可以显著改善前壁心肌梗死患者左室收缩功能和心肌代谢,移植术后8个月仍能观察到重建心肌效应。
英文摘要:
      Objective: To evaluate the early and med-term outcomes of transplantation of autologous bone marrow mesenchymal stem cells(BMSCs) and mononucleus cells(BMMNCs) to treat coronary heart disease. Methods: Fourteen patients with coronary heart disease complicated with myocardial infarction were enrolled in this prospective, nonrandomized, control study(8 patients in cell transplantation group, 6 in control group). BMSCs and BMMNCs were isolated and cultured for 2-3 weeks, and (0.9-3.5) × 106 BMSCs plus(1.6-6.1) × 106 BMMNCs were transplanted into the myocardial infracted area in cell transplantation group through intracoronary way. All patients underwent 3-month and 8-month follow-up for 6 minutes test, 2D Doppler echocardiogram and SPECT. Results: After 3 months and 8 months follow-up, cardiac function was improved. Six minutes distance was prolonged from 320.72 ± 60.47 to 406.88 ± 68.31 and 484.79 ± 81.00. Left ventricular ejection fraction(LVEF) was increased from 42.5% to 49.5% and 54%. The infarct defected regions was reduced from 45.5% to 39% and 25% in 6 patients with anterior myocardial infarction. In control group, 2D Doppler echocardiogram and SPECT were improved in 3 months but not improved 8 months after PCI. In cell transplantation group, 2 patients with inferior myocardial infarction had no significant efficacy. Conclusion: The preliminary study showed that in the patients with coronary heart disease complicated with anterior myocardial infarction, transplantation of BMSCs and BMMNCs could improve cardiac function and cardiac metabolism. The effects could last 8 months.
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