大网膜联合组织工程心肌移植改善心肌梗死后大鼠心功能  

Great Omentum Wrapped Engineer Heart Tissue Transplantation Preserves Cardiac Function in Myocardial Infarction Rats

作　　者：周骐[1] 周建业[1] 胡盛寿[1] 胡平[2] 

机构地区：[1]中国医学科学院中国协和医科大学阜外心血管病医院外科卫生部心血管疾病再生医学研究重点实验室,北京100037 [2]清华大学化工系高分子材料研究所,北京100084

出　　处：《中国胸心血管外科临床杂志》2008年第6期432-437,共6页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：国家自然科学基金资助项目(30772147);中国博士后基金资助项目(20080430335)~~

摘　　要：目的将骨髓间充质干细胞(MSCs)种植于共聚乙交酯-丙交酯(PLGA)补片上构建组织工程心肌(EHT),在大鼠心肌梗死模型上观察大网膜增加EHT血供,改善微环境后对心脏间质胶原重塑及心功能的影响,为心肌梗死的外科治疗提供新的途径。方法结扎SD大鼠左冠状动脉,制作心肌梗死模型。以大鼠MSCs为种子细胞构建EHT,将符合心肌梗死标准的18只鼠随机分成3组,每组6只,A组:网膜包裹EHT;B组:单纯EHT移植;对照组:单纯心肌梗死;另设假手术组(n=6):仅开胸,不结扎冠状动脉及EHT移植。EHT植入后4周,用二维超声心动图检测心功能,彩色室壁运动(CK)方法检测梗死部位心室壁运动,取标本做天狼猩红染色在光学显微镜下观察心肌改变。结果A组EHT植入后4周部分PLGA纤维降解,梗死部位心肌间质胶原含量较B组和对照组明显减少(P<0.05)。CK检查显示A组梗死部位心室壁运动较B组和对照组明显改善(P<0.05);A组左心室收缩期末内径(LVESD)和左心室舒张期末内径(LVEDD)较对照组和B组明显减小(P<0.05),左心室射血分数(LVEF)、左心室缩短分数(LVFS)较对照组和B组明显增大(P<0.05)。结论大网膜包裹MSCs-PLGA构建的EHT覆盖于梗死心肌表面能改善心肌梗死后间质胶原重塑和梗死部位心室壁运动,有利于心功能的恢复。Objective Engineer heart tissue （EHT） was constructed with mesenchymal stem cells （MSCs） and poly lacticacid-CO-glycolic acid （PLGA）, and grafted onto the surface of myocardial infarction rats. We hypothesized that great omentum wrapping would increase EHT blood supply and ameliorate EHT microenvironment which is in favor of cardiac collagen remodling and heart function. We hope that omentun wrapped EHT could provide a valuable strategy for surgically myocardial infarction therapy. Methods MSCs were isolated from SD rats. Eight weeks after SD rats were subjected to left anterior descending （LAD） ligation, 18 rats were enrolled and divided into three groups, group A（n=6）： great omentum wrapped MSCs-PLGA EHT implantation; group B （n=6）：MSCs-PLGA EHT implantation; control group （n= 6）： the myocardial infarction; the sham group （n= 6）= only opened and closed chest, underwent LAD ligation, but no EHT implantation. Four weeks after transplantation, the following variables were evaluated： specimen stained with picrosirius red, left ventricle function evaluated by echocardiography, infarction ventricular wall motion by color kinesis （CK）. Results Hearts of group A showed significantly less fibrosis than group B and control group （P〈0. 05）. Infarction ventricular wall motion assessed by CK indicated significantly improvement in group A compared with group B and control group （P〈 0. 05）. Four weeks after transplantation, cardiac echocardiography showed left ventricle ejection fraction was lower in control group and group B compared with group A （P〈0.05）. Conclusion Transplantation of MSCs-PLGA EHT with great omentum wrapping ameliorated infarction ventricular collagen remodeling, ameliorated infarction ventricular wall motion and preserved left ventricular function.

关 键 词：骨髓间充质干细胞 大网膜 心肌梗死 组织工程 重塑 

分 类 号：R542.22[医药卫生—心血管疾病]