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临床研究  

Clinical study of autologous intracoronary bone marrow mononuclear cells transplantation in acute anterior myocardial infarction treatment

作　　者：施海明[1] 金波[1] 常锡峰[1] 罗心平[1] 朱军[1] 李勇[1] 沈伟[1] 李剑[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

出　　处：《中国心血管杂志》2007年第4期267-270,I0002,共5页Chinese Journal of Cardiovascular Medicine

基　　金：上海市卫生局科研课题资助项目(沪卫教2005-37)

摘　　要：目的采用随机、对照、前瞻性的临床试验,评价经冠状动脉自体骨髓单个核细胞(BMMNCs)移植治疗急性前壁心肌梗死的有效性和安全性。方法入选26例急性前壁心肌梗死患者,BMMNCs移植组(14例)行经皮冠状动脉介入(PCI)治疗联合经冠状动脉自体BMMNCs移植;对照组(12例)接受PCI治疗。结果3个月后,BMMNCs移植组左室射血分数(LVEF)由(54.29±5.47)%提高至(59.21±5.54)%(P<0.05),与对照组比较,无统计学差异(P>0.05);PET/CT示BMMNCs移植组心肌18F-FDG代谢显像明显改善;明尼苏达生活质量评分的改变亦具有统计学意义。结论经冠状动脉自体BMMNCs移植治疗急性前壁心肌梗死安全而有效,可能与BMMNCs转分化为心肌细胞改善心功能有关。　Objective To evaluate the efficacy and safety of autologous intracoronary bone marrow mononuclear cells（BMMNCs） transplantation in acute anterior myocardial infarction（MI） treatment.Methods Twenty-six patients with acute anterior MI were included.After emergency percutaneous coronary intervention（PCI） for the guilty coronary artery,14 patients were transplanted with autolougous BMMNCs（BMMNCs group）via coronary artery.The other 12 patients were taken as control.Results After 3 months of follow-up,left ventricular ejection fraction（LVEF） increased significantly in BMMNCs group [from（54.29±5.47）% to（59.21±5.54）%,P〈0.05];while when compared with control group,there was no statistical significance（P〉0.05）.Positron emission tomography（PET）/CT demonstrated significant 18F-FDG myocardial metabolism imaging improvement after transplantation of autologous BMMNCs.Minnesota living with heart failure questionnaire indicated significant improvement in BMMNCs group compared with control group.Conclusions Autologous intracoronary BMMNCs transplantation for acute anterior MI treatment is safe and effective.The underlying mechanism may result from the differentiation of BMMNCs into myocardial cells.

关 键 词：心肌梗死 细胞移植 心肌再生 骨髓 正电子发射断层扫描 

分 类 号：R542.22[医药卫生—心血管疾病]