急性前壁心肌梗死不同时间窗骨髓干细胞移植的疗效观察  

Effect of bone marrow stem cell transplantation in different time windows on patients with acute anterior myocardial infarction

作　　者：江隆福[1] 李恒栋[1] 

机构地区：[1]宁波市第二医院,浙江宁波315010

出　　处：《现代实用医学》2010年第3期259-261,273,共4页Modern Practical Medicine

基　　金：宁波市科技计划项目;编号:2007A610065

摘　　要：目的探讨急性前壁心肌梗死患者不同时间窗经梗死前降支自体骨髓干细胞移植对心功能、心肌存活的影响及其安全性。方法对36例急性前壁心肌梗死并行急诊经皮冠状动脉介入的患者进行分组,5d内细胞移植10例,10～15d内移植10例,余16例常规治疗。三组患者均于移植术前、术后6个月行单光子发射计算机体层摄影双核素心肌显像、超声心动图及动态心电图检查。结果术后6个月,干细胞移植组心肌存活、左室形态及心功能等各项指标均较常规治疗组改善明显(p<0.05),10～15d组较5d组优势更明显。结论骨髓干细胞经冠脉移植治疗急性前壁心肌梗死可以显著改善左室收缩功能和心肌存活,时间窗上应选择10～15d更加合适。Objective To study the efficacy and safety of transpantation of autologous bone marrowmesenchymalstem cell（BMSCs） for treating of patients with acute anterior myocardial infarction（AMI）.Methods 36 patients with AMI were divided into three groups：5-day group（10 patients,PCI ＋ drug ＋ cell transp lantation in 5 days）,10 ～ 15-day group（10 patients,PCI ＋ drug ＋ cell transp lantation in 10 ～ 15 days） and routine treatment group（16 patients,PCI ＋ drug）.Baseline and follow up evaluations including Doppler echocardiogram,SPECT and Holter before and 6 months after transpantation of BMSCs were recorded.Results Myocardial viability,left ventricle shape and systolic function and ventricles reconstitution improved significantly in transplantation group（P〈0.05）;and they improved more obviously in 10 ～ 15-day transplantation group compared with 5-day group.Conclusion Intracoronary transplantation of autologous BMSCs is safe and effective on improving the prognosis of patients with acute anterior myocardial infarction,which can be attributed to elevated myocardial viability and left ventricle systolic function,and transplantation in 10 ～ 15 days is more reasonable.

关 键 词：骨髓移植 骨髓祖代细胞 心肌梗塞 

分 类 号：R542.22[医药卫生—心血管疾病]