直接注射移植自体骨骼肌成肌细胞对成年犬急性心肌梗死后心脏功能的影响  

Effect of transplantation of autologous skeletal myoblasts via intramyocardial injection on cardiac function of adult canines with acute myocardial infarction

作　　者：窦克非[1] 杨跃进[1] 邱洪[1] 慕朝伟[1] 阮英茆[1] 陈纪林[1] 高润霖[1] 陈在嘉[1] 

机构地区：[1]中国医学科学院,中国协和医科大学,心血管病研究所,阜外心血管病医院内科冠心病诊治中心,北京市100037

出　　处：《中国临床康复》2005年第30期60-62,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:观察急性心肌梗死区心肌内直接注射移植自体骨骼肌成肌细胞对心肌梗死犬左室功能及心室重构的影响。方法:①实验于2002-03/2003-09在中国医学科学院心血管病研究所(阜外心血管病医院)分子医学中心完成。选用杂种成年犬16只。②以机械法结合IA型胶原酶与胰蛋白酶的二步酶消化法的改良成年犬骨骼肌成肌细胞培养方法进行细胞原代培养及扩增。③结扎冠状动脉前降支中段,建立急性心肌梗死模型后,将动物随机分为2组:对照组和成肌细胞注射组,每组8只。对照组:在梗死区点状注射生理盐水;成肌细胞注射组:在梗死区点状注射成肌细胞悬浮液。④冠状动脉结扎前、结扎后15min及4周时以漂浮导管测定左室功能指标(左室压力最大上升和下降速率,心排出量),将左室压力最大上升和下降速率与左心室收缩末压相除获得其校正值,结扎后4周行超声心动图检查(包括左室舒张末容积、左室收缩末容积、每搏输出量及左室射血分数),计算室壁节段运动指数和体现左室重构的球形指数。⑤组间比较分析用t检验,组内不同时段数据分析用配对t检验。结果:成肌细胞注射组的2只动物分别死于心肌梗死模型建立过程中的室颤和术后猝死,对照组的死亡动物中2只死于术后猝死,1只死于术后严重感染,进入结果分析11只犬(成肌细胞注射组6只,对照组5只)。①左室功能参数的变化:对照组冠状动脉结扎后即刻左室压力最大上升和下降速率、左室压力最大上升和下降速率/左心室收缩末压和心排出量明显低于结扎前,且术后4周时心排出量仍明显低于结扎前(P<0.05);成肌细胞注射组术后4周各指标基本恢复至冠状动脉结扎前水平(P>0.05);其收缩功能指标明显高于对照组(P<0.01),也比冠状动脉结扎后显著上升(P<0.05),而左室压力最大下降速率和左室压力最大下降速率/左心室收缩末压�AIM： To study the curative effect of transplantaion of autologous skeletal myoblasts by intramyocardial injection on the function and reconstruction of left ventricle in adult canines with acute myocardial infarction （AMI）. METHODS：The experiment was carried out in the Molecular Medicine Center, Institute of Cardiovascular Disease, Chinese Academy of Medical Sciences ＆ Peking Union Medical College from March 2002 to September 2003. Sixteen adult canines were selected in the experiment. Autologous skeletal myoblasts were procured by using a modified culture method （two- step digestion method consisting of collagenase IA and trypsin combined with mechanical mincing）. AMI model was established by ligation of left anterior descending branch （LAD）. Then the 16 canines were randomized into two groups with 8 ones in each group： control group （injection of normal saline in infarct area） and treatment group （injection of myoblast suspension in infarct area）. To evaluate the curative effect, we used Swan-Ganz catheter monitoring determine functional index of left ventricle including the maximal rate of left ventricular pressure increase or decrease （LVP±dP/dtmax） and cardiac output so as to obtain correction value （±dP/dtmax / end-systolic pressure） before ligation, and 15 minutes and 4 weeks after ligation, and echocardiography to end systolic volume （ESV）, end-diastolic volume （EDV）, stroke volume （SV）, and ejection fraction （EF） so as to calculate Wall Motion Score Index and globe leaf head four weeks after ligation. Student＇s t test and paired t test were applied for inter-group and intra-group comparison, respectively. RESULTS：Two canines in the treatment group died during the model establishment （one for ventricular fibrillation, and one of sudden death）, and three canines in the control group died （two of sudden death, and another one for severe infection）. Totally eleven canines were involved in the result analysis, including six ones in the treatmen

关 键 词：肌 骨骼 移植 自体 心室功能 左 

分 类 号：R542.2[医药卫生—心血管疾病]