自体骨髓单个核细胞移植对扩张型心肌病大鼠心功能的影响  

Experiment study of transplantating mononuclear bone marrow cells to affect heart function of dilated cardiomyopathic rats

作　　者：黄海怡[1] 黄佐[2] 侯健[3] 周智慧[4] 胡国梁[2] 

机构地区：[1]上海交通大学医学院附属第九人民医院心内科,上海200013 [2]第二军医大学长征医院心内科 [3]第二军医大学长征医院血液科 [4]第二军医大学长海医院超声科

出　　处：《临床心血管病杂志》2006年第3期154-157,共4页Journal of Clinical Cardiology

摘　　要：目的：研究大鼠骨髓单个核细胞（MBMCs）移植对扩张型心肌病（DCM）大鼠心功能的影响。方法：无菌条件下取成年雄性近交系Wistar大鼠股骨和胫骨，常规抽取骨髓，分离制备MBMCs悬液。对150只成年雄性近交系Wistar大鼠皮下注射大剂量异丙肾上腺素170mg／kg，qd，连续2d，建立DCM模型。造模2周后，以左室射血分数（LVEF）〈45％为标准人选试验组，将大鼠随机分成移植组（28只）、对照组（26只）和假手术组（26只），开胸，直视下在左心室前壁行心肌注射。移植组注射4，6二乙酰基-2-苯基吲哚（DAPI）标记的MBMCs悬液10μl（含5×10^6个细胞）；对照组注射等量磷酸盐缓冲溶液（PBS）；假手术组仅开胸和关胸。于移植后4和8周，分批分组进行超声心动图、血流动力学检测。结果：与对照组和假手术组比较，移植组左室收缩和舒张末容积（LVEDV、LVESV）减小（均P〈0．01），短轴缩短率（FS）和LVEF增大（均P〈0．01）；左室收缩压力（LVPES）、压力速率最大值（dp／dtmax）明显升高（均P〈0．01），而左室舒张末压力（LVPED）显著下降（P〈0．01）。对照组和假手术组心腔呈进行性扩大，心肌室壁运动功能障碍明显，心功能逐渐恶化，在第4周时，2组分别有3只和2只出现心室腔反流，反流量0．002～0．006ml；在第7和8周时，分别有2只和1只出现反流，量较4周多，最大达0．011ml。结论：MBMCs移植可有效防止DEM心室腔扩大，促进血管和心肌再生，修复受损心肌，有效改善心功能。Objective： To investigate the effect of transplanting mononuclear bone marrow cells （MBMCs） heart function of dilated cardiomyopathic rats. Method： Rats （n = 150） received two subcutaneous injections of 170 mg isoproterenol per kilogram of body weight to establish dilated cardiomyopathy（DCM） model after two weeks. MBMCs were isolated from the rats, which were labeled with DAPI before transplantation for identification. Then the labeled cells （5×10^6） or PBS were transplantated into the left ventricular free wall （transplantation group, n = 28; control group, n = 26）. Sham-operated rats （n = 26） underwent the surgery but not transplantation. At 4 th and 8 th week after transplantation, heart function was assessed by echocardiography and Langendorff preparation. Result： Compared with control and sham-operated groups, in transplantation group, echocardiography and langendorff preparation showed that the left ventricular end diastolic volume （LVEDV）、LV end-systolic volume （LVESV） decreased, while the fractional shortening （FS） and ejection fraction （EF） increased （P〈0.01）; LV systolic pressure （LVPs） and diastolic pressure to diastolic time maximum （dp/dt） also obviously elevated, but LV end-diastolic pressure （LVPED） decreased （P 〈 0.01）. While in control and sham operation group, heart cavity was gradually dilated, chamber wall were inconsistent, heart function was deteriorated, at 4th week, some animal hearts even appeared left ventricle countereurrent （control group, n = 3; sham operated group, n = 2）, flux was from 0.002 to 0.006 ml, at 7 th and 8 th week, 2 and 1 animals respectively appeared countercurrent, the max flux was 0.011ml. Conclusion： Transplantation of MBMCs into DCM myocardium can repaire necrosis cardiac muscle and improve heart function effectively.

关 键 词：心肌病 扩张型 细胞移植 骨髓单个核细胞 心室功能 左 

分 类 号：R542.2[医药卫生—心血管疾病]