小型猪自体骨髓单个核细胞移植对心肌梗死后心室重构的影响  

Effects of autologous transplantation of bone marrow mononuclear cells on ventricular remodeling after myocardial infarction in swines

作　　者：徐晓蓉[1] 温尚煜[1] 郭艳红[1] 李昭屏[1] 潘震华[1] 毛节明[1] 周春燕[2] 高炜[1] 

机构地区：[1]北京大学第三医院心内科,教育部分子心血管病重点实验室,北京市100083 [2]北京大学医学部生化与分子生物学系

出　　处：《中国介入心脏病学杂志》2007年第2期99-102,共4页Chinese Journal of Interventional Cardiology

基　　金："十五"国家科技攻关计划项目(2004BA714B-1)

摘　　要：目的观察小型猪自体骨髓单个核细胞移植对改善心肌梗死后心室重构的影响并探讨可能的机制。方法采用经冠状动脉球囊堵闭法制作小型猪前壁心肌梗死动物模型,喂养3周后随机分为经皮冠状动脉内骨髓单个核细胞(BM-MNC)移植组(n=7)和磷酸盐缓冲液(PBS)对照组(n=5)。BM-MNC移植组注入BM-MNC悬液10mL至梗死相关血管,对照组注入PBS10mL至梗死相关血管。继续喂养4周后采用超声心动图、左心室造影评价心脏结构和功能,用羟脯氨酸消化法测定心肌胶原含量,以天狼猩红染色后观察胶原纤维形态。结果移植后4周BM-MNC移植组左心室舒张末内径(LVEDD)较移植前缩小(40.40±4.51mm比45.88±4.15mm,P=0.026),左心室射血分数(LVEF)较移植前增加(47.50%±9.07%比41.16%±9.83%,P=0.020);对照组LVEDD较移植前有所增加(48.50±9.31mm比42.40±7.29mm,P=0.328),射血分数无明显变化。两组移植前后LVEDD及LVEF的差值比较,差异均有统计学意义(-5.48±0.71mm比6.10±1.39mm,P=0.046;5.33%±2.88%比0.20%±1.38%,P=0.030)。BM-MNC移植组在交界区及远离区胶原含量均较对照组减少(1.32±0.49μg/mg比0.71±0.35μg/mg,P=0.047;0.32±0.05μg/mg比0.21±0.08μg/mg,P=0.034),胶原排列整齐;梗死区胶原含量和形态两组无明显差异。结论BM-MNC移植治疗可改善心肌梗死后心室重构过程,心肌胶原含量的减少可能是其重要的机制之一。Objective To study the effects of bone marrow mononuclear cells （MNCs） transplantation on left ventricular （LV） remodeling and its potential mechanism in swine myocardial infarction models. Methods The left anterior descending coronary arteries of swines were obstructed by balloon to create myocardial infarction models. Three weeks later, MNCs （ n = 7 ） or PBS （ n = 5 ） were injected into the infarction related coronary arteries through balloon catheter. The cardiac function were measured by echocardiography and ventriculargraphy. Collagen amount was also assessed at 4 weeks after transplantation. Results At 4 weeks after transplantation, LV end-diastolic dimension decreased in the BM-MNC group than before （40. 40 ± 4. 51 mm vs. 45. 88 ± 4. 15 ram, P = 0. 026 ）, but increased in the control group （48.50 ±9. 31 mm vs. 42.40 ±7. 29 mm, P =0. 328）. Left ventricular function was improved from 41.16% ±9.83% to 47.50% ±9.07% in the BM-MNC group （P =0.020） but there was no significant change in the control group. Significant differences existed between the 2 groups in their absolute change before and after the procedure in both LV dimension and LV function （ P = 0. 046 and P = 0. 030 respectively）. The results showed reduction of collagen content in the border and the remote infarct regions in the BM-MNC group compared with the control （P = 0. 047 and P = 0. 034 respectively）. Conclusion BM-MNCs transplantation regulates collagen content in heart and attenuates the degree of post-MI LV dilation and the development of infarction area. This effect of BM-MNCs transplantation may be one of the mechanisms which intervene ventricular remodeling following myocardial infarction.

关 键 词：骨髓细胞 心肌梗死 心室重构 干细胞移植 

分 类 号：R654.2[医药卫生—外科学]