冠状动脉旁路移植术中骨髓干细胞移植对心肌梗死后心功能的影响  

The Influence of heart function after transplantation of autologous bone marrow stem cells in corondry artory by pass grafting

作　　者：封锡清[1] 高杰[1] 渠敬明[1] 周亚[1] 王虎[1] 景华[2] 

机构地区：[1]徐州市第三人民医院心胸外科,江苏徐州221005 [2]南京军区南京总医院心胸外科,江苏南京210002

出　　处：《医学研究生学报》2007年第4期382-384,387,共4页Journal of Medical Postgraduates

基　　金：江苏省自然科学基金资助项目(批准号:BK2002098)

摘　　要：目的:探讨在冠状动脉旁路移植术(CABG)中用自体骨髓干细胞(BMSC)移植对心肌梗死区域心功能的影响。方法:选取20例心肌梗死患者随机分成CABG+BMSC移植组(移植组,n=10)和CABG组(对照组,n=10)两组。对照组只行CABG,移植组在CABG的同时用制备BMSC悬液在梗死区域作多点局部注射。术后两组均随访4周和8周,观测左心室功能和梗死区域的节段性室壁运动情况以及血供情况。结果:对照组术后第4周心功能有所改善,但与术前比较无统计学意义,第8周改善明显(P<0.05)。移植组第4周,心功能参数均比术前有明显改善,左室射血分数(LVEF)明显提高(P<0.05),左室舒张末期直径(LVEDD)较术前明显缩小(P<0.05),左室舒张末期容积(LVEDV)较术前明显缩小(P<0.05),梗死区域节段性室壁运动改善;QRS记分明显降低,而且低于对照组(P<0.05);心肌核素灌注断层显像(ECT)放射性核素缺损区显著小于术前,且小于对照组(P<0 05)。结论:CABG改善了心肌的血供情况,BMSC移植则有效地缩小了梗死坏死区域,改善了节段性室壁异常运动,使心脏功能得到改善。objective：To evaluate the influence of heart function after transplantation of autologous bone marrow stem cells in coronary artery bypass grafting （CABG）. Methods：We randomly allocated 20 patients with myocardial infarction （MI） and divided into two groups, CABG group （ group control, n = 10） and CABG plus transplantation of bone marrow stem cells（BMSC） （group transplantation,n = 10）. Results： Compared with control group, transplantation group was associated with a significant increase in global left ventricular ejection fraction（ P 〈 0.05 ）, improved regional wall motion in the infarct zone and profoundly reduced end-diastolic left ventricular volumes （P 〈 0.05 ）, the QRS scores were lower （P 〈 0.05 ） at 4 th week and 8 th week follow-up. Echocardiography revealed a profound enhancement of regional contractile function after 4 weeks. Single-photon emission computed tomography（SPECT） perfusion scan analysis revealed a significant increase in myocardial viability in the infarct zone and significant small in the infact areas （P 〈 0. 05）. Conclusion：In patient with myocardial infarction in CABG, ejections of autologous BMSC appears to be feasible and safty and may beneficially affect postinfarction remodeling processes.

关 键 词：心肌梗死 冠状动脉旁路移植术 移植 骨髓干细胞 

分 类 号：R654.2[医药卫生—外科学]