定量核素心肌显像评价骨髓干细胞移植治疗急性心梗疗效的对照研究  

Control study of myocardial radionuclide imaging in evaluating the efficacy of bone marrow stem cells transplantation in patients with acute myocardial infarction

作　　者：闫新慧[1] 谢建[1] 高传玉[1] 王子超[1] 

机构地区：[1]河南省人民医院,河南郑州450003

出　　处：《中国临床医学影像杂志》2007年第3期178-180,共3页Journal of China Clinic Medical Imaging

基　　金：河南省重大科技攻关项目(编号0422030300)

摘　　要：目的:研究定量核素心肌显像联合动态心电图监测评价急性心梗患者骨髓干细胞移植术的疗效与安全性。方法:36例急性心梗患者,病史小于4周,心功能Ⅱ～Ⅲ级行择期冠状动脉介入(PCI)术。随机分为对照组[PCI+生理盐水(NS)]与试验组[PCI+自体骨髓单核细胞(BM-MNCs)]。对照组与试验组在PCI术结束后分别通过大腔导管于梗塞相关血管注入NS与BM-MNCs。对所有患者于PCI术前、术后45天、术后90天行静息99mTc-SPECT心肌显像、ECG、24h动态心电图。结果:①术后45天试验组与对照组静息99mTc-SPECT灌注缺损区面积较术前分别缩小34.32%和23.05%(P<0.05),两组组内比较差异有统计学意义;术后90天试验组与对照组静息99mTc-SPECT灌注缺损区面积较术后45天分别缩小14.77%和3.82%(P<0.05),但两组组内比较仅试验组差异有统计学意义。②24h动态心电图监测,室性心律失常及心动过缓在术前、术后45天、术后90天同期两组间比较差异无统计学意义(P>0.05)。结论:定量核素心肌显像评价骨髓干细胞移植治疗急性心梗疗效较有价值。该手术治疗急性心梗有一定疗效,并且不增加心律失常的发生率。Objective： To evaluate the therapeutic efficacy and safety of bone marrow stem cells transplantation in patients with acute myocardial infarction （AMI） using the quantitative analysis of myocardial radionuclide imaging and holter. Methods： Thirty-six patients, who had AMI within 4 weeks, underwent percutaneous coronary intervention（PCI） after AMI with NYHA Ⅱ-Ⅲ class. The patients were divided into trial group [PCI＋normal saline （NS）] and control group [PCI＋autologous bone marrow mononuclear cells （BM-MNCs）] randomly. NS or BM-MNCs was infused into the infarct related artery through the guiding catheter after PCI in control group and trial group respectively. ECG, holter, SPECT were assessed before PCI, 45d, 90d after that. Result： ①SPECT scan： results showed perfusion defect decreased 34,32% and 23.05% than base-line at 45d in trial and control group respectively, the difference between the two methods was significant （P〈0.05）; and significant difference was also found in both groups. The perfusion decreased 14.77% and 3.82% at 90d compared with 45d in trial and control group respectively （P〈0.05）; but significant difference was not found in both groups, only in trial group. ②24h electrocardiographic monitoring demonstrated that there was no difference in the occurrence of ventriarrhythmia or bradycardia between before PCI, and 45d, 90d after that （/〉〉0.05）. Conclusions： The quantitative analysis of myocardial radionuclide imaging is a feasihle approach to assess the efficacy and safety of bone marrow stem cells transplantation in patients with AMI. And bone marrow stem ceils transplantation has some efficacy in patients with AMI and does not increase the incidence of malignant arrhythmias.

关 键 词：心肌梗塞 干细胞移植 放射性核素显像 

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