骨髓细胞治疗细胞死亡相关性心脏病的证据与进展  

Progress in bone marrow cells in the treatment of cell death-related heart diseases

作　　者：戚龙[1] 温国政[1] 李艳兵[1] 张洪存[1] 潘玉良[1] 

机构地区：[1]承德北方医院急诊科暨心二科,河北省承德市617000

出　　处：《中国组织工程研究与临床康复》2007年第46期9341-9345,共5页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：学术背景:应用自体骨髓细胞治疗细胞死亡相关性心脏病后可显著改善心功能水平。然而,近年的研究并没有发现骨髓细胞任何成分分化成心肌细胞的临床证据,心功能改善与心肌细胞再生的直接联系并不明确。目的:总结骨髓细胞治疗细胞死亡相关性心脏病的研究进展。检索策略:由该论文的研究人员应用计算机检索PubMed数据库1977-04-01/2007-04-01的相关文献,检索词"bonemarrowcells,heartfailure,Cardiacfunction"。同时计算机检索CNKI中国期刊全文数据库2004-01/2007-04期间的相关文章。共检索到66篇文献,对资料进行初审,纳入标准:①与骨髓细胞治疗心肌细胞丧失和心功能不全密切相关。②同一领域选择近期发表或在权威杂志上发表的文章。排除标准:重复性研究或meta类文章。文献评价:文献的来源主要是骨髓细胞治疗心肌梗死和心力衰竭的有关随机对照实验。所选用的30篇文献中,3篇为综述,其余均为临床或动物实验研究。资料综合:①随着急性心肌梗死抢救的成功率的提高和老龄人口的到来,以细胞丧失为特点的心力衰竭的发生率不断升高,但心力衰竭治疗尚无本质性的突破。②骨髓细胞的局部移植可以有效改善急性心肌梗死和心力衰竭的近期心脏功能。③先前的动物实验研究表明,心肌梗死后心功能的改善可能源于骨髓干细胞分化或融合成有功能的心肌细胞。但近来的实验及临床研究一直未能发现这方面的有力证据。④最新的研究发现,心脏修复通过骨髓先驱细胞介导的旁分泌血管生成通路,这个发现可能为揭开骨髓细胞治疗细胞死亡相关性心脏病的机制开辟了新的道路。⑤尽管骨髓干细胞治疗心肌细胞丧失的确切机制尚不完全清楚,但多数动物及临床研究证明有效而且安全,进一步的深入研究是有价值的。结论:骨髓细胞治疗细胞死亡相关性心脏病总体上安全�BACKGROUND： The application of bone marrow cells on cell death-related heart diseases may improve cardiac function. However, there is no clear evidence having been found that any cell in bone marrow can differentiate into myocardial cells, and the relationship between the improvement on cardiac function and myocardial cell regeneration also remains unknown. OBJECTIVE： To summarize the research progress of bone marrow cells for therapy on cell death-related heart diseases. RETRIEVE STRATEGY： Using key words of ＂bone marrow cells, heart failure, cardiac function＂, a computer-based search of Pubmed database was undertaken to identify the articles published between Apnl 1^th 1977 and April 1^st 2007 in English. Meanwhile, the CNKI Full-text Database was searched for the similar articles published between January 2004 and April 2007, with same key words in Chinese. All the data were selected primarily, and 66 related articles were collected. Inclusive criteria： ①the articles closely linked with bone marrow cells for treatment of myocardial cell loss and heart failure.Gas for the same field, the articles published recently or in core joumals were preferred. Exclusive criteria： meta analysis or repeated articles. LITERATURE EVALUATION： The selected articles mostly included random and contrast trials on the application of bone marrow cells for myocardial infarction and heart failure. In these 30 articles, there were 3 involved review data and the others remained clinic or animal studies. DATA SYNTHESIS： ①Following a high survival rate of acute myocardial infarction and the coming of aging era, heart failure which is characteristic as myocardial cell loss is continually growing, otherwise, there is no root and branch breakthrough in treatment of heart failure.②The transplantation of bone marrow cells in impaired heart area may achieve a significant improvement in patients or animals with acute myocardial infarction or heart failure. ③Previous animal trials show that the improvement of car

关 键 词：骨髓细胞 心力衰竭 心功能 

分 类 号：R541.6[医药卫生—心血管疾病]