应用自制心内膜注射导管移植自体骨髓间充质干细胞治疗急性心肌梗死  

A new developed endocardium injection catheter applying to autologous bone marrow mesenchymal stem cells transplantation in acute myocardial infarction

作　　者：程芮[1] 王士雯[1] 曹丰[1] 张友荣[2] 徐勇[1] 孟玲[1] 王韫芳[2] 李艳华[2] 卢才义[1] 裴雪涛[2] 

机构地区：[1]解放军总医院老年心血管病研究所,北京100853 [2]军事医学科学院输血研究所,北京100850

出　　处：《中华老年心脑血管病杂志》2005年第6期407-410,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家973计划(2001CB509906);国家863计划重大专项(2002AA205051;2003AA205160);北京市科委重大项目(H020220010190)

摘　　要：目的探讨心内膜注射导管应用于干细胞移植治疗心肌梗死的可行性。方法将移植组和对照组分别经自制的心内膜注射导管梗死心肌内移植体外扩增的自体骨髓间充质干细胞(mesenchymal stem cells,MSCs)和无血清培养,移植前后、6周及3个月超声评价左心功能,3个月时取梗死周围心肌组织冷冻切片,免疫荧光法鉴定结蛋白(desmin)和心肌特异性肌钙蛋白I(cTnI)的表达。结果自制的可调节注射导管,制作方法简单,安全有效;MSCs移植数量平均为(3.81±0.09)×107个;左室射血分数正常为(69.3±2.5)%,心肌梗死后降为(34.9±0.9)%,移植后3个月升至(56.7±0.8)%,超声提示室壁运动增强;与对照组相比,移植组左室收缩末压、左室舒张末压及左室压力最大上升/下降速率改善更明显(均为P<0.01),荧光显微镜下可见DAPI标记胞核为蓝色荧光的移植细胞,免疫组化提示结蛋白及cTnI表达阳性。结论实验用注射导管可以完成细胞的心内膜移植,移植的MSCs体内定位明确,移植后心功能改善,并有心肌相关蛋白的表达。Objective To demonstrate the therapeutic potential of intramyocardial transplantation of autologous mesenchymal stem cells （MSCs） in the setting of acute myocardial ischemia. Methods The purified no serum medium MSCs were autologously transplanted into target ischemia endocardium by injection catheter. Left ventricular function （LVEF） was estimated by echocardiography at 6 weeks and 3 months after transplantation. The fluorescence microscope with immunohistochemistry was used to examine the desmin and cTnI around infarcted region 3 months later. Results The injection catheter could be easily developed, both conveniently and safely handled. The swine MSCs were harvested 3.81 ± 0.09 ×10^7 cells after cultured three generations over 2 -3 weeks. LVEF were 69.3±2.5% before AMI, 34.9±0.9% post AMI and 56.7±0.8% after MSCs transplantation respectively. LVEF was improved significantly at 3 months with wall motion enhanced. LVESP, LVEDP and LV ± dp/dtmax were improved significantly in MSCs transplantation group （ P 〈 0.01）. DAPI-labeled MSCs marked all positive cells around infarcted myocardium and expressed markers of myocardium phenotype were shown positive stain of desmin and cTnI. Conclusion The experimental endocardium injection catheter can be used in experimental study with its convenient manipulation. The transplanted MSCs locate definitely, expressed markers of myoeardium phenotype result in the heart function improved significantly.

关 键 词：骨髓移植 干细胞 心肌梗塞 心内膜 注射 

分 类 号：R542.22[医药卫生—心血管疾病]