自体骨髓干细胞移植联合瓣膜手术治疗扩张型心肌病  

Combined procedure of surgical treatment and cell transplantation for dilated cardiomyopathy： initial results

作　　者：范慧敏[1] 卢蓉[1] 马亮[1] 李杨[1] 刘中民[1] 

机构地区：[1]同济大学附属东方医院心胸外科,上海200120

出　　处：《中华胸心血管外科杂志》2008年第2期95-97,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：本课题受上海市重点专科心力衰竭专项资助

摘　　要：目的探讨瓣膜手术联合自体骨髓干细胞移植术对扩张型心肌病治疗效果。方法2003年3月至2006年10月，选择8例扩张型心肌病病人，男5例，女3例；年龄15～56岁。术前射血分数（EF）0．15～0．32，平均0．26±0．08。心功能（NYHA）Ⅲ级4例；Ⅳ级4例。术日取病人自身骨髓50ml，分离自体骨髓干细胞。5例行瓣膜置换术，3例行瓣膜成形术；瓣膜手术后，取培养的自体骨髓干细胞，左心室心肌内注射。结果全组无手术死亡，未发生严重手术并发症。随访12～42个月，平均18个月。术后6个月内EF改变不明显，但心功能明显改善，生活质量明显提高。术后1年EF开始改善。超声组织多普勒以及DISA心肌灌注，代谢显像显示心脏功能术后明显改善。结论联合应用瓣膜手术加自体骨髓干细胞移植术可能改善扩张型心肌病治疗效果。Objective This study evaluated the effects of combined procedure of surgical treatment and cell transplantation on dilated cardiomyopathy. Methods Eight patients （5 men and 3 women） with moderate to severe mitral regurgitation from end-stage dilated cardiomyopathy underwent surgery. Four patients were in flmctional class （FC） Ⅳ, six were in FC Ⅲ. There age ranged from 15 to 56 years. The preoperative ejection fraction （EF） ranged from 0.15 to 0.32 （mean 0.26 ± 0.08 ）. Mitral valve replacement was performed in 5 patients and mitral valve repair in 3. Auto-bone marrow mononuclear ceils were harvested, isolated, washed, and resuspended for direct injection after surgical procedure. Results All patients survived and were discharged from the hospital. After a mean follow-up period of 18 months （12 -42 months）. Echocardiography showed postoperative ejection fraction and wall movement velocity increased after 6 months. Radionuclide ventriculography showed myocardial perfusion improved significantly. Conclusion Combined procedure of surgical treatment and cell transplantation led to significant improvement in cardiac fimction in patients with dilated cardiomyopathy.

关 键 词：心肌病 扩张型 心脏瓣膜假体植入 心脏外科手术 干细胞移植 

分 类 号：R686[医药卫生—骨科学]