犬自体骨髓单个核细胞经冠状动脉移植重建梗死心肌  

Repair of infarcted myocardium by autologous intracoronary mononuclear bone marrow cell transplantation in dogs

作　　者：朱智明[1] 高连如[1] 费宇行[1] 王志国[1] 张宁坤[1] 陈宇[1] 贺声[1] 丁青艾[1] 

机构地区：[1]海军总医院心内科,北京100037

出　　处：《第二军医大学学报》2004年第9期936-939,共4页Academic Journal of Second Military Medical University

基　　金：海军科研基金 (0 0 - 332 2 )

摘　　要：目的 :探讨选用含有原始干细胞 /多系祖细胞及基质细胞的骨髓单个核细胞 (MBMC) ,经冠状动脉移植重建犬梗死心肌 ,观察其修复、重建梗死心肌及改善心功能的效果。方法 :经皮穿刺球囊封堵前降支成功建立心肌梗死动物模型并存活约 1周的杂种犬 10条 ,平均分为细胞移植组和对照组。细胞移植术前 1d分离 MBMC,以 DAPI标记 ,温箱保存过夜。常规冠状动脉造影、PTCA,在球囊闭塞前降支条件下注入 MBMC(每次 4× 10 6个细胞 ,2 ml) ,气囊保持充盈 2 min后恢复灌注 2 min,重复注入 3次。分别于术前及术后 2个月行超声心动图检查 ,动物放血处死后取心脏前壁和下壁冰冻切片 ,荧光显微镜观察并照相。 结果 :移植组术后与术前及对照组比较 ,平均左室舒张末容量和左室收缩末容量减少、EF和 FS增加 (P<0 .0 5 ) ;对照组则左室舒张末容量和左室收缩末容量明显增加、FS减少 (P<0 .0 5 )。细胞移植组左室收缩及舒张内径和梗死长度均较移植前缩小 ,梗死部位室壁厚度较移植前增加 (P<0 .0 5 ) ;而对照组梗死区室壁变薄。在细胞移植组前壁心肌组织冰冻切片中可以看到心肌细胞核发黄绿色荧光 ,发现带绿色荧光的丝状肌丝肌管 ,移植犬的下壁和对照组的前壁可见心肌细胞核发出光亮较移植组前壁淡的自发黄绿色荧光 ,而均未发现有带?Objective:To investigate the feasibility and efficiency of autologous intracoronary mononuclear bone marrow cell transplantation for treatment of dog myocardial infarction. Methods: Ten male dogs underwent permanent left anterior descending coronary arteries occlusion by balloon to establish myocardial infarction(MI) model. About 1 week after extensive MI, dogs were divided into transplantation group (n=5) and control group(n=5). Echocardiography study was performed before and 60 d after implantation to assess left ventricular remodeling and function. Dogs were sacrificed and specimens were harvested 60 d post-implantation;histologic sections were examined under a fluorescent microscopy. Results: The left ventricular end-diastolic volume(LVEDV) and left ventricular end-systolic volume(LVESV) decreased in transplantation group, while EF and FS increased significantly(P<0.05) and SV insignificantly. The LVEDV and LVESV in control group increased obviously, while FS decreased significantly(P<0.05) and SV and EF insignificantly. The LVESV in transplantation group was significantly lower than that of control group(P<0.05) while LVEDV insignificantly; EF and FS in transplantation group was significantly higher than that of control group(P<0.05) while SV insignificantly. The LV diastolic and systolic enternal diameter and the length of infarction area decreased after transplantation and the thickness of infarction area increased(P<0.05), while the thickness in control group decreased. In transplantation group the cardiac anterior wall was positively stained under fluorescent microscope with green fluorescent myofilaments and myotubes, while the fluorescence in inferior wall of transplantation group and anterior wall of control group was weaker and with no fluorescent myofilaments and myotubes.Conclusion: Autologous mononuclear bone marrow cells can be implanted and survive in the infarcted myocardium, which can attenuate infarct thinning, myocardial remodeling and dysfunction, and may provide a new approach for myocard

关 键 词：心肌梗死 骨髓单个核细胞 细胞移植 

分 类 号：R542.22[医药卫生—心血管疾病]