经冠脉自体骨髓单个核细胞移植治疗扩张型心肌病的随机对照研究  

Evaluation of dilated cardiomyopathy by autologous intracoronary mononuclear bone marrow cell transplantation in humans in a prospective randomized controlled clinical trial

作　　者：金波[1] 施海明[1] 罗心平[1] 管一晖[2] 朱军[1] 朱萍[3] 沈伟[1] 王彩萍[1] 

机构地区：[1]复旦大学附属华山医院心内科,上海200040 [2]复旦大学附属华山医院PET中心,上海200040 [3]复旦大学附属华山医院血液病研究室,上海200040

出　　处：《复旦学报（医学版）》2007年第1期76-79,共4页Fudan University Journal of Medical Sciences

基　　金：上海市卫生局科研课题(沪卫教2005-37)

摘　　要：目的采用随机、对照、前瞻性的临床试验,旨在评价经冠脉自体骨髓单个核细胞(BMMNCs)移植治疗扩张型心肌病的有效性和安全性。方法连续入选26例扩张型心肌病患者,细胞移植组(14例)行经冠脉自体BMMNCs移植联合标准药物治疗;对照组(12例)接受标准药物治疗。结果3个月后,细胞移植组的左室射血分数(LVEF)由(29.21±4.41)%提高至(31.08±4.54)%(P=0.004),与对照组比较,无统计学差异(P=0.216);PET/CT示心肌13N-NH3灌注和18F-FDG代谢显像显著改善;氮末端脑钠素前体(NT-proBNP)、6min步行试验和明尼苏达生活质量评分的改变均具有统计学意义。结论经冠脉自体BMMNCs移植治疗扩张型心肌病安全而有效,可能是通过BMMNCs转分化为心肌细胞和血管内皮细胞而改善心功能。Purpose To evalute dilated cardiomyopathy by autologous intracoronary mononuclear bone marrow cells（BMMNCs） transplantation in our prospective randomized controlled clinical trial. Methods Twenty-six patients with dilated cardiomyopathy were included. After standard therepy for chronic heart failure, 14 patients were transplanted with autolougous BMMNCs via coronary artery. Another 12 patients were treated by standard therepy alone. Results After 3 months of follow-up, LVEF had increased significantly within the cell therapy group [from （29.21 ± 4.41） % to （31.08 ± 4.54） % ,P = 0. 004], while there was no statistical significance compared with control group （P = 0. 216）. PET/CT were performed for the cell therapy group and showed significant improvement in ^13N-NH3 myocardial perfusion and ^18 F-FDG metabolism imaging. Further cardiac examinations（NTproBNP,influence of 6 min walking test and Minnesota living with heart failure questionnaire） indicated significant difference in comparing to the baseline. Conclusions Autologous intracoronary BMMNCs transplantation for dilated cardiomyopathy is safe and effective under clinical conditions. The marked therapeutic effect may be contributed stem-associated myocardial regeneration and neovascularization.

关 键 词：扩张型心肌病 细胞移植 血管新生 心肌再生 骨髓 

分 类 号：R542.2[医药卫生—心血管疾病]