骨髓MSCs移植对急性心肌梗死后心室肌重构和心功能的影响  

Influence of mesenchymal stem cells implantation on ventricular remodeling and heart function after acute myocardial infarcion

作　　者：黄日太[1] 朱洪生[1] 薛松[1] 连锋[1] 黄钢[2] 刘建军[2] 陶如琦[3] 

机构地区：[1]上海交通大学医学院仁济医院心胸外科,上海200127 [2]上海交通大学医学院仁济医院核医学科,上海200127 [3]上海交通大学医学院仁济医院心超室,上海200127

出　　处：《上海交通大学学报（医学版）》2008年第4期359-362,共4页Journal of Shanghai Jiao tong University:Medical Science

基　　金：国家自然科学基金(30070748)~~

摘　　要：目的探讨骨髓间质干细胞(MSCs)移植对急性心肌梗死后心室肌重构和心功能的影响。方法抽取香猪骨髓,体外分离MSCs,经5-氮胞苷诱导转化。将诱导后的MSCs(实验组)或等量生理盐水(对照组)注射至香猪急性心肌梗死的心肌区内。3周和6周后,超声心动图观察两组心肌结构和心功能改变情况,并应用单光子发射计算机断层扫描行心肌显像检查,抗BrdU抗体DAB显色确定梗死区内移植干细胞的存在。结果MSCs移植3周和6周后,实验组左室室壁和室间隔的厚度较对照组增加而心室腔较对照组小,实验组左室射血分数、左室短轴缩短率以及室壁增厚率明显高于对照组。SPECT显像示对照组有明显的充盈缺损,而实验组在梗死区有部分心肌显像。实验组心肌梗死中央、梗死边缘区、局部注射心肌标本可见BrdU标记的细胞。结论MSCs移植可在梗死区再生心肌组织,增加梗死区心肌的厚度,减轻心肌变薄和心室腔扩大程度,因而可以减缓心室重构的进程;同时,MSCs移植还可增加心肌的收缩力,改善心功能。Objective To study the influence of mesenchymal stem cells（MSCs） implantation on ventricular remodeling and heart function after myocardial infarcion. Methods Bone marrow was aspirated from Gui-zhou Xiang swines.After being isolated,cultured and co-cultured with 5-azacytidine,either autologous MSCs（experiment group） or a comparable volume of physiologic saline（control group） were injected into the infarcted myocardium.Three and six weeks later,echocardiographic measurement was performed to assess the myocardial structure and heart function,and single photon emission computed tomography（SPECT） was employed for myocardial imaging.Implanted stem cells were detected by the anti-Brdv antibody DAB with HE staining. Results Left ventricular ejection fraction（EF）,fractional shortening and wall thickening were higher in experiment group than control group.The thickness of the ventricular wall and septum was found increased while the left ventricular chamber size was smaller in experiment group.It was indicated by SPECT that three and six weeks after implantation,there was obvious image defect in control group while in experiment group there were some imaging areas in the infarcted area.Brdv-labelled cells were observed in the central part of and around the infarcted area.Conclusion Implantation of MSCs into the infarcted myocardium is believed to attenuate the remodeling process,inhibit the extent of wall thinning and dilatation of the ventricular chamber.MSCs implantation may also improve the contractile ability of the myocardium and heart function.

关 键 词：骨髓间质干细胞 急性心肌梗死 心室肌重构 超声心动图 单光子发射计算机断层扫描 

分 类 号：R542.22[医药卫生—心血管疾病]