急性心肌梗死患者外周血干细胞动员的安全性观察  

The Safety of Autologous Circulating Blood Stem Cell Mobilization in Patients with Acute Myocardial Infarction (AMI)

作　　者：李占全[1] 张明[1] 金元哲 袁龙[1] 张薇薇[1] 刘莹[1] 崔丽杰[1] 赵红岩[1] 赵颖军[1] 徐桂萍[1] 石蕴琦[1] 崔然[1] 孟锦[1] 郭翠艳[1] 居乃新[1] 李彤[1] 侯平[1] 李惠君[1] 陈晓明[1] 

机构地区：[1]辽宁省人民医院辽宁省心血管病医院心内科心血管病研究室,辽宁沈阳110016

出　　处：《中国医刊》2004年第7期26-28,共3页Chinese Journal of Medicine

摘　　要：目的　观察急性心肌梗死 (AMI)患者外周血干细胞动员的可行性与安全性。方法　自 2 0 0 3年 11月至 2 0 0 4年 1月收治的 2 7例AMI患者 ,入院后在常规急性心肌梗死治疗 (药物与介入治疗 )基础上给予包涵体型G -CSF(商品名 :惠尔血 )或分泌型G -CSF(商品名 :金磊赛强 ) ,3 0 0～ 60 0 μg/d皮下注射 ,连续 5天 ,第 6日分离外周血干细胞 ,进行经皮经腔冠状动脉内移植自体外周血干细胞进一步治疗急性心肌梗死。在外周血干细胞动员时观察有无骨痛 ,乏力 ,皮疹 ,发热 ,胃肠道反应 (恶心、呕吐、便秘 ) ,心绞痛或心衰加重 ,及一些少见的、严重的并发症 :自发性脾破裂、严重化脓性感染、高凝状态、自身免疫性疾病等发生。结果　在外周血干细胞的动员期间不良反应发生率为 44 .4%( 12 /2 7) ;其中骨痛发生率为 18.5 %( 5 /2 7) ,低热约 11.1%( 3 /2 7) ,乏力约 7.4%( 2 /2 7) ,皮疹约 3 .7%( 1/2 7) ,心衰加重约 3 .7%( 1/2 7) ,无其他少见的、严重并发症发生。结论　急性心肌梗死患者行外周血干细胞动员时 ,无影响AMI病程的严重并发症发生 ,在AMI病人中应用G -CSF安全可行。Purpose Observe the safety of autologous circulating blood stem cell mobilization in patients with acute myocardial infarction (AMI). Method 27 patients with AMI were randomly allocated to receive either inclusive type Granulocyte Colony-Stimulating Factor (G-CSF), or excrete type G-CSF to mobilize the stem cell. The patients received the dose of G-CSF 300-600μg/day , by hypodermic injection ,and the duration of applying G-CSF was 5 days .In the process of the mobilization of the circulating blood stem cell, the following side effects had been paid attention to, such as: bone pain, tetter, fever, gastrointestinal effects ( nausea ?vomit? coprostasis ),deteriorated of angina or heart failure and some rare effects (spontaneous spleen rupture, severe purulent infection, hypercoagulable state, autologous immune diseases). Results There were total 12 cases with complications during the mobilization of circulating blood stem cell. The incidence of complications during mobilization was 44.4%(12/27), including bone pain being 18.5 %(5/27)?fever being 11.1 %(3/27)?pale being 7.4 %(2/27)?tetter being 3.7 %(1/27)?deterioration of heart failure being 3.7 %(1/27).Conclusion In patients with AMI,mobilization of autologous circulating blood stem cell is feasible and safe.

关 键 词：急性心肌梗死 外周血干细胞动员 安全性 可行性 移植 

分 类 号：R542.22[医药卫生—心血管疾病]