经冠状动脉自体骨髓单个核细胞移植治疗急性前壁心肌梗死的研究  

Effects of acute myocardial infarction(AMI) tredted by transplanting autologous mononuclear bone marrow cell through intracoronary route

作　　者：许丹[1] 尚小明[1] 姜玉如[1] 纪征[1] 姜玉凤[1] 卢峰[1] 张春来[1] 李霞[1] 

机构地区：[1]河北医科大学唐山临床医学院唐山工人医院心内一科,河北唐山063000

出　　处：《中国心血管杂志》2006年第4期261-265,共5页Chinese Journal of Cardiovascular Medicine

基　　金：国家高技术研究发展计划(863)计划;(编号:2005AA205232)

摘　　要：目的观察经冠状动脉将自体骨髓单个核细胞(MBMC)移植治疗急性前壁心肌梗死的疗效。方法本实验为开放性、前瞻性、非随机、对照研究。选取40例急性前壁心肌梗死患者,根据患者的意愿分为干细胞移植组(20例,接受急诊经皮冠状动脉介入治疗(PCI)+标准药物+经冠状动脉注入骨髓单个核细胞治疗)和常规治疗对照组(20例,接受急诊PCI+标准药物治疗)。两组患者分别于术前、术后3个月、术后6个月进行6min步行试验、多普勒超声心动图9、9 mTc-MIBI心肌灌注显像检查并记录发病6个月内主要临床事件。结果同对照组相比,6min步行试验、超声心动图、心肌ECT术前与术后3个月时两组无明显差异P>0.05,术后6个月,干细胞移植组较对照组心功能改善明显P<0.05,差异有统计学意义。结论本研究提示,自体骨髓单个核细胞经冠状动脉移植修复急性心肌梗死是安全有效的,细胞移植所显示的改善心功能的效果,可能与心肌和血管再生,限制和逆转了心室重构有关。Objective To investigate the possibility, safety and efficacy of the repair of infracted myocardium and improvement of cardiac function by transplanting autologous mononuclear bone marrow cell （MBMC） through intracoronary route in patients with AMI. Methods Fourty patients with AMI were enrolled in this open prospective negative trabant control study and divided into PCI ＋ drug ＋ cell transplantation group and PCI ＋ drug group. Baseline and follow up evaluations included floor walking test in 6 min, Doppler echocardiogram and technetium-99m methoxyisobutylisonitrile （^99mTc- MIBI） emission computerized tomographic of heart before and 3month, 6 month after operation, recorded the MACE at the same time. Results All transplantation surgery were safe. 6 patients had limited ST segment elevation in leads associated with inserted artery and 2 patients temporary cardiac enzymes elevation. Floor walking test in 6 min cardiac infarction inpatients were improved： Ejective fraction （EF） increased and better wall motion by echocardiogram and ECT. But in control group cardiac function was not improved obviously. Conclusion Present study demonstrates that intracoronary transplantation of autologous MBMC is safe and effective. The marked therapeutic effect may be attributed to MBMC asso- ciated myocardial regeneration and neovascularization as well as the action of cytokines and growth factors.

关 键 词：急性心肌梗死 骨髓单个核细胞 心肌移植 6min步行试验 

分 类 号：R542.22[医药卫生—心血管疾病] R457.7[医药卫生—内科学]