自体外周血干细胞移植对急性心肌梗死患者左室重构和心功能的影响  

Assessment of left ventricular remodeling by echocardiography after transplantation of autologous peripheral blood stem cells in patients with myocardial infarction

作　　者：张翔[1] 张彤[1] 李文[1] 刘超[1] 杨俊[1] 

机构地区：[1]云南省第一人民医院心内科,昆明市650032

出　　处：《中国心血管病研究》2008年第5期349-351,共3页Chinese Journal of Cardiovascular Research

摘　　要：目的评价自体外周血干细胞移植对急性心肌梗死患者左室重构和心功能的影响。方法共有65例急性心肌梗死患者入选本项前瞻性、非随机、开放试验(其中35例患者为细胞移植组,30例为对照组)。两组患者均接受标准的介入治疗和药物治疗,细胞移植组的35例患者同时接受自体外周血干细胞移植。两组患者在移植前及移植后6个月应用超声心动观察左室形态、室壁运动情况及左室功能指标的变化。结果6个月后干细胞移植组术前后比较左室舒张末期容LVEDV)明显缩小[(136.4±14.9)ml比(120.6±19.6)ml,P<0.01],左室收缩末期容量(LVESV)明显缩小[(84.5±18.9)ml比(70.5±14.9)ml,P<0.01],左室射血分数(LVEF)明显增高[(48.8±7.2)%比(56.5±7.4)%,P<0.01]。左室壁节段性运动指数(WMSI)明显降低[(1.41±0.21)比(1.10±0.15),P<0.01];左室射血前时间/射血时间比值显著降低[(0.46±0.08)比(0.40±0.07),P<0.01],左室舒张功能指标:舒张早期峰值速度(Em)增高,舒张晚期峰值速度(Am)降低,Em/Am增高。对照组治疗前后比较上述指标均有改善,但差异无统计学意义,两组术后上述指标比较差异有统计学意义。结论经皮经腔冠状动脉内自体干细胞移植术能明显改善急性心肌梗死患者的左室功能,减小左室容量,阻止或延缓左室重构,改善心功能。Objective To assess the effect of transplamtation of autologous peripheral blood stem cells on the left ventricular remodeling after acute myocardial infarction （AMI）. Methods 65 patients with AMI were enrolled in this prospective, open-labeled study （35 patients in cell transplantation group. 30 patients in control group）,all patients were trented by standard drug therapy and percutaneous coronary intervention （PCI）. The two groups were evaluated in the morphous of left ventricle, the change in left ventricular function using echocardiogra- phy before and after transplantation in sixth months. And the index of segmentation movement of ventricular wall. Results Baseline parameters were similar between the two groups. Left ventricular function was significantly improved 6 months after transplantation of autologous peripheral blood stem cells compared to baseline（left ventricular end diastolic volume （LVEDV） [ （ 120.6±19.6 ）ml vs （ 136.4±14.9）ml, P〈0.01 ], left ventricular end-systolic volume [ （70.5±14.9 ）ml vs （84.5± 19.9 ）ml, P〈0.01 ], global left ventricular function ejection faction（ LVEF ） [ （ 56.5±7.4 ）% vs （48.8±7.2）%,P〈0.01 ] ,WMSI （ 1.10±0.15 vs 1.41±0.21 ,P〈0.01 ）,LVPEP/ET （0.40±0.07 vs 0.46±0.08） ,P〈 0.01 ）, while theres parameters remand unchanged in the control group ,these parameters has statistics difference between the two groups before and after stem cell treatment. Conclusion Our resul indicate that imtracoronary transphantation of augologous peripheral blood stem cells could improve global left ventricular function and left ventricular remodeling attenuated at six-month follow-up.

关 键 词：超声心动描记术 心肌梗死 干细胞 心室复建 

分 类 号：R542.22[医药卫生—心血管疾病]