动态三维超声心动图评价基因转染骨髓基质细胞移植治疗慢性缺血心肌实验研究  

Assessment of chronic ischemic myocardium before and after transplantation of bone marrow stromal cell transferred by angiogenin gene using dynamic three-dimensional echocardiography

作　　者：徐静[1] 赵宝珍[1] 黄盛东[2] 王韦[1] 贾宝成[2] 崔勇[2] 龚德军[2] 周桂花[1] 王虹[1] 

机构地区：[1]第二军医大学长海医院超声科,上海200433 [2]第二军医大学长海医院胸心外科实验室,上海200433

出　　处：《中国医学影像技术》2005年第5期677-680,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的评价动态三维超声心动图(DTDE)对基因转染骨髓基质细胞(BMSCs)移植治疗慢性缺血心肌研究价值.方法在猪冠脉左旋支放置Ameroid环建立慢性心肌缺血模型;4周后分组注射编码血管生长素(ANG)基因腺病毒(Ad)转染的自体BMSCs(Ⅰ组)、编码ANG基因的Ad(Ⅱ组)、单纯BMSCs(Ⅲ组)和空Ad磷酸盐缓冲液(Ⅳ组).再4周后行病理学检查.分别于正常状态、置环后4周和注射后4周开胸时采集二维图像,应用TomTec 4D cardio-view软件进行三维重建和分析,观测各时期左室形态、侧后壁(LPW)回声和运动、左室舒张和收缩末期容积(LVEDV, LVESV)和射血分数(LVEF)变化.结果慢性心肌缺血模型均出现左室重构和LPW室壁运动减弱、回声增强,LEDV明显增大,LVEF明显降低(P＜0.01).注射后4周, Ⅰ～Ⅲ组均不同程度出现左室重构现象减轻,LVEDV缩小(P＜0.05),LVEF增大(P＜0.05),其中以Ⅰ组治疗效果最好,侧后壁室壁回声减弱,运动增强(P＜0.05).Ⅳ组与缺血时无明显差异(P＞0.05).结论 DTDE对评价基因转染细胞移植治疗慢性缺血心肌具有重要应用价值.Objective To investigate the value of dynamic three-dimensional echocardiography (DTDE) in detecting chronic ischemic myocardium before and after transplantation of bone marrow stromal cells (BMSCs) combined with angiogenic gene transfer. Methods Four weeks after chronic ischemic myocardium models were set up, groupⅠ-Ⅲ were intramyocardially administrated by BMSCs transferred by adenovirus mediated angiogenin gene (Ad·ANG), Ad·ANG, BMSCs and phosphate buffer respectively. Four weeks later, pathological investigation was performed. DTDE was performed by TomTec 4D Cardio-View software at normal state, 4 weeks after ameroid placement and 4 weeks after administration respectively. Results The end-diastolic and end-systolic volumes of left ventricle (LVEDV, LVESV) were all increased and the ejection fraction (LVEF) all decreased 4w after Ameroid placement ( P <0.01). After administration, there were no significant changes of these parameters among group Ⅳ and those before administration and other administrated groups ( P < 0.05 ). The left ventrical remodeling were all diminished in group Ⅰ-Ⅲ. LVEDV, LVESV were all decreased and LVEF were all increased. The greatest increase of LVEDV, LVESV and greatest decrease of LVEF were found in group Ⅰ. Conclusion DTDE is a feasible approach to assess changes of LV volumes and systolic function in chronic ischemic myocardium before and after gene transfer and cell transplantation therapy.

关 键 词：超声心动描记术 三维 心肌缺血 骨髓细胞 移植 基因 

分 类 号：R540.4[医药卫生—心血管疾病] Q95-33[医药卫生—内科学]