自体骨髓单个核细胞植入对心肌梗死后心脏功能的影响  

Improvement of cardiac function by transplanting autologous mononuclear bone marrow cells into myocardial infarction scar and the periphery

作　　者：孙勇新[1] 赵强[1] 潘翠珍[2] 夏利民[1] 徐德民[1] 陈安清[1] 王哲[1] 

机构地区：[1]复旦大学附属中山医院心血管外科,上海200032 [2]复旦大学附属中山医院超声心动图室,上海200032

出　　处：《复旦学报（医学版）》2008年第3期431-435,共5页Fudan University Journal of Medical Sciences

摘　　要：目的探讨骨髓单个核细胞植入对心肌梗死后心脏功能的影响。方法以冷冻损伤的方法建立新西兰种家兔心肌梗死模型,分为骨髓单个核细胞组(mononuclear bone marrowcells,MN-BMCs组)和对照组,各8只。4周后,MN-BMCs组中将提取分离的MN-BMCs,植入心肌梗死及其边缘区,对照组于心肌梗死及其边缘区注射相应体积的I MDM完全培养液。以超声心动图分析细胞植入前后心脏功能改善情况。结果MN-BMCs植入心肌梗死及其边缘区可以改善局部及整体心脏功能:细胞移植4周后两组之间比较,MN-BMCs组局部心脏功能明显优于对照组,表现为MN-BMCs组比对照组心肌梗死区室壁厚度增加,[(4.81±0.55)mmvs(3.94±0.54)mm,P<0.05];收缩期和舒张期心肌梗死区室壁运动速度明显增加[分别为(8.20±0.77)cm/svs(7.00±0.56)cm/s,P<0.05;(8.51±0.93)cm/svs(6.75±0.57)cm/s,P<0.05]。细胞移植4周后,MN-BMCs组整体心脏功能亦优于对照组,表现为MN-BMCs组比对照组心腔减小,LVDD分别为(14.89±1.36)mmvs(16.24±1.31)mm(P<0.05),LVSD分别为(10.48±1.32)mmvs(12.29±1.48)mm(P<0.05);MN-BMCs组左心室收缩功能明显改善,左室射血分数及缩短分数提高,LVEF分别为(65.25±5.73)%vs(57.00±5.81)%,P<0.05;LVFS分别为(30.25±3.73)%vs(24.88±3.95)%,P<0.05。结论骨髓单个核细胞植入心肌梗死及其边缘区可以改善心肌梗死后心脏功能。Objective To test the therapeutic effectiveness in cardiac function after transplanting mononuclear bone marrow cells （BMCs） into myocardial infarction scar and its periphery. Methods Myocardial infarction was induced by cryoinjury in 16 rabbits. Four weeks after cardiac cryoiniury generation, 16 rabbits were equally assigned for cell transplantation and control. Twenty-four hours before cell transplantation, under general anesthesia, bone marrow was aspirated from the right thigh bone. MN-BMCs were isolated. An 1.5 mL suspension containing 1.1 × 10^7 to 7.2×10^7 mononuclear BMCs was injected into the infraction scar and its periphery under direct visualization. In the control group, the rabbits received the same volume of IMDM culture media. Transthoracic echocardiography was performed to observe the changes of regional and global cardiac function 4 weeks after cardiac cryoinjury and cells transplantation, respectively. Results No difference was observed on baseline of cardiac function between the 2 groups before MN-BMCs transplantation. In MN-BMCs group, 4 weeks after cell transplantation, infarction wall thickness was increased （P〈0. 05） ; regional wall motion of the in-farction scar had also improved （P〈0. 05）. The relative reduction of left ventricular end-diastolic diameters and end-systolic diameters were found; Left ventricular ejection and shorting fraction were increased in the MN-BMCs group, respectively （P〈0. 05）. On the contrary, in the control group, compared with the baseline data, 4 weeks after IMDM culture media injection, infarction wall thickness was decreased （P〈0. 05）; regional wall motion of the infarction sear also became weakened （P〈0.05）. The relative extension of left ventricular end-diastolic diameters and end-systolic diameters were found, respectively （P〈0. 05）; left ventricular ejection and shorting fraction decreased in the control group, respectively （P〈0. 05）. Moreover, the hearts with transplanted cells had better regional and glob

关 键 词：骨髓单个核细胞 心脏功能 心肌梗死 

分 类 号：R541[医药卫生—心血管疾病]