前壁心肌梗死患者自体骨髓单个核细胞移植治疗的可行性研究  

The feasibility of autologous mononuclear bone marrow cells transplantation in patients with anterior myocardial infarction

作　　者：刘健[1] 王伟民[1] 孙宁玲[1] 张萍[1] 刘开彦[2] 汪素[2] 王茜[3] 臧越[4] 杨松娜[1] 王靖[2] 陆道培[2] 郭继鸿[1] 

机构地区：[1]北京大学人民医院心内科,100044 [2]北京大学人民医院血液病研究所,100044 [3]北京大学人民医院核医学科,100044 [4]北京大学人民医院放射科,100044

出　　处：《中国介入心脏病学杂志》2005年第2期76-80,共5页Chinese Journal of Interventional Cardiology

摘　　要：目的　评价经冠状动脉内注射自体骨髓单个核细胞治疗心肌梗死患者的可行性。方法　本项前瞻性、非随机、对照研究入选2 2例陈旧性前壁心肌梗死患者(其中1 4例患者为细胞治疗组,8例患者为常规治疗组)。两组患者均接受标准的介入治疗和药物治疗,细胞移植组的1 4例患者采用Over the Wire(OTW )球囊导管将自体骨髓单个核细胞缓慢注入前降支。结果　细胞移植组中1例患者因支架内急性血栓形成而死亡。其余1 3例和常规治疗组的8例患者术中及术后无心肌缺血及心律失常的发生。两组患者均于术后3个月和6个月随访,并行6分钟步行试验、超声心动图、心肌双核素和心脏核磁等检查。3个月的检查结果提示,细胞移植组左室射血分数[( 4 0 .1 2±5 .52 ) %vs( 50 . 37±7. 31 ) % ,P =0 . 0 0 0 1 ],与常规治疗组差异有统计学意义[( 50 .37±7 .31 ) %vs ( 4 4. 0 9±3 .50 ) % ,P =0 . 0 35]。结论　前壁心肌梗死患者经冠状动脉内行自体骨髓单个核细胞移植具有良好的可行性,可以显著改善左室收缩功能。Objective To evaluate the feasibility of autologous mononuclear bone marrow cells (BMCs) transplantation in patients with anterior myocardial infarction. Methods Twenty-two patients were enrolled in this prospective, nonrandomized, control study (14 patients in cell transplantation group; 8 in control group). All patients underwent standard percutaneous coronary intervention (PCI) and drug therapy. 14 patients in the cell transplantation group were transplanted with autologous mononuclear (BMCs) via a over-the-wire (OTW) balloon catheter slowly placed into the left anterior descending (LAD) coronary artery during inflation. Results One patient in the cell transplantation group died of acute drug eluting stent thrombosis. The other 13 patients and the 8 patients in the control group had no procedure related complications and ventricular arrhythmia. All patients in both groups underwent 3-month and 6-month follow-up, 6 minutes test, 2D Doppler echocardiogram, single photon emission computed tomography and cardiac magnetic resonance imaging (MRI). After 3 months of follow-up, a significant increase of left ventricular ejection fraction (LVEF) determined by ultrasonic cardiography was found [(50.37±7.31)% vs (40.12±5.52)% before transplantation, P =0.000?1] and was also significantly greater compared with the control group [(50.37±7.31)% vs (44.09±3.50)%, P =0.035]. Conclusion The result indicates that selective intracoronary transplantation of autologous mononuclear BMCs seems to be feasible and may improve the left ventricular systolic function.

关 键 词：心肌梗死患者 细胞移植治疗 前壁 自体骨髓单个核细胞移植 6分钟步行试验 急性血栓形成 左室射血分数 左室收缩功能 动脉内注射 超声心动图 冠状动脉内 治疗组 细胞治疗 对照研究 药物治疗 介入治疗 球囊导管 心律失常 

分 类 号：R473.5[医药卫生—护理学] R457.7[医药卫生—临床医学]