经冠状动脉注射法自体骨骼肌成肌细胞移植治疗兔急性心肌梗死  

Treating acute myocardial infarction with autologus skeletal myoblast transplantation by intracoronary-infusion in rabrits

作　　者：朱红[1] 宋湘[2] 金丽娟[2] 金鹏[2] 刘娴[2] 李学奇[2] 

机构地区：[1]首都医科大学宣武医院综合科,北京100053 [2]哈尔滨医科大学附属第四医院心内科,黑龙江哈尔滨150001

出　　处：《心脏杂志》2009年第2期179-182,共4页Chinese Heart Journal

基　　金：黑龙江省自然科学基金项目资助(ZJY04-03);黑龙江省博士后启动基金资助(LRZ-05023)

摘　　要：目的观察经冠状动脉注射自体骨骼肌成肌细胞(SM)移植到兔急性心肌梗死(AMI)区后的生长分化特点和疗效。方法取日本大耳白兔45只,随机分为经冠脉注射SM移植组、对照组和假手术组,各15只。SM移植组取臀肌分离、纯化SM并体外扩增。结扎兔左冠脉前降支(LAD),建立AMI模型。再灌注后,SM移植组经冠脉注射自体SM悬液1 ml(5×106个细胞)。对照组以相同的方法建立AMI模型,注入等量的无血清培养液。假手术组除不结扎左前降支外,其余操作均同对照组。4周后,通过HE染色和抗5-溴脱氧尿核苷(BrDU)抗体、抗骨骼肌特异性慢β-肌凝蛋白重链(slow-MHC)抗体的免疫组化染色评价移植细胞的转归。术后24 h和4周,以超声心动图仪测量3组的左室射血分数(LVEF)和左室短轴缩短率(FS)。结果SM移植组在术后4周,HE染色后可在梗死区内找到新生的多核肌样细胞。抗BrdU抗体和抗Slow-MHC抗体的免疫组化染色呈阳性。术后24 h,假手术组的LVEF和FS明显高于对照组和SM移植组(P<0.01)。而术后4周,与对照组比较,假手术组和SM移植组的LVEF和FS明显改善(P<0.01)。结论经冠脉注射法移植自体SM可在AMI区存活,修复受损心肌并提高心脏的功能。AIM To observe the growth, differentiation and curative effect of autologus skeletal myo- blasts （SM） following their transplantation into acute myocardial infarction （AMI） region by intracoronary infusion. METHODS Forty-five white Japanese big-ear rabbits were randomly divided into three groups： SM group, control group and sham operation group, with 15 animals were in each group. Gluteus were obtained for SM separation, purification and expansion in vitro. AMI model was obtained by ligating the coronary artery left anterior descending branch （LAD）. 5 x 106 Bromodeoxy uridine （BrdU） labeled SM were infused into LAD after reperfusion. Equal serum-free medium alone was infused into control group after the ligation of the LAD. Except for the LAD ligation, sham operation group underwent the same procedures as control group. HE stain and anti-BrdU, anti-myosin-heavy chain（ MHC, slow） immu- nohistochemistry stain were performed to evaluate the differentiation of the transplanted cells 4 weeks after transplantation. Left ventricle ejection fraction （LVEF） and shortening fraction （FS） were measured by echocardiography 24 hours and 4 weeks after transplantation. RESULTS Four weeks after transplantation, muhinucleate muscle cells were seen in the MI region of the SM group by HE stain, and anti-BrdU and anti-MHC （slow） antibody immunohistochemistry showed positive. Twenty-four hours after transplanta- tion, the LVEF and FS of animals in the sham operation group were better than those in SM and control group （P 〈 0.01 ）. Four weeks after transplantation, the LVEF and FS of animals in SM group and sham operation group were better than those in control group （ P 〈 0.01 ）. CONCLUSION Autologus SM transplanted into AMI region by intracoronary infusion can survive in the AMI region, repairing the impaired myocardium and improving the cardiac function.

关 键 词：心肌梗死 成肌细胞 细胞移植 冠状血管 

分 类 号：R542.22[医药卫生—心血管疾病]