对比研究自体骨髓单个核细胞移植对心肌梗死面积的影响  

Contrast study on the effects of autologons bone marrow mononuclear cells transplantation on myocardial infarct size

作　　者：张华[1] 宋先忠[1] 王俊生[1] 郑诒章 史芳涛 

机构地区：[1]河南省安阳市人民医院心外科,455000

出　　处：《中国医师进修杂志》2010年第29期16-19,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨冠状动脉搭桥术时同期行自体骨髓单个核细胞移植对心肌梗死面积的影响。方法选择心肌梗死患者40例，按随机数字表法分为Ⅰ组和Ⅱ组，每组20例，按下述方法进行研究：Ⅰ组施行冠状动脉搭桥术治疗，Ⅱ组施行冠状动脉搭桥术＋自体骨髓单个核细胞移植，移植细胞数为（6．84±2．88）×10^7个。随访6个月，比较两组的疗效。结果两组围手术期均无死亡病例发生，随访6个月患者全部存活，无恶性心律失常等主要心脏不良事件发生。术后6个月，Ⅱ组左室射血分数与Ⅰ组比较明显升高[（57．40±5．21）％比（50．75±5．88）％，t=3．79，P〈0．05]，NYHA心功能分级与Ⅰ组比较也明显改善[（1．30±0．47）级比（1．85±0．59）级，t=3．27，P〈0．05]。单光子发射型计算机体层摄影结果提示Ⅱ组心肌梗死面积较Ⅰ组明显减小，差异有统计学意义[（14．57±5．20）％比（20．45±5．18）％，t=3．59，P〈0．05]。结论冠状动脉搭桥术时同期行自体骨髓单个核细胞移植可有效地缩小心肌梗死面积，使心脏功能得到改善，且安全、可行。Objective To study the effects ofautologous bone marrow mononuclear cells （BMMCs） transplantation during coronary artery bypass grafting （CABG） on myocardial infarct size. Methods Forty myocardial infarction patients diagnosed by coronary angiography （CAG） and SPECT and confirmed at surgery were enrolled and randomly assigned CABG alone （group I ） or CABG with intramyocardial or intracoronary injection of autologous BMMCs （group Ⅱ ）, 20 cases in each group. Baseline and followed up evaluations included SPECT and NYHA-FC before and after 6 months operation, recorded the major adverse cardiac events （MACE） at the same time. The number of autologous BMMCs injected was （6.84 ±2.88） × 10^7 in group Ⅱ. Results There was no procedure-related complication during 6 months followed up in all patients. After 6 months operation,left ventricular ejection fraction in group Ⅱ was significantly higher than that in group Ⅰ [ （57.40 ± 5.21 ）% vs. （50.75 ±5.88）% ,t = 3.79,P 〈 0.05 ],NYHA-FC in group Ⅱ was significantly improved than that in group [ [ （ 1.30 ± 0.47） grades vs. （ 1.85± 0.59） grades, t = 3.27,P 〈 0.05],SPECT showed myocardial infarct size in group Ⅱ was significantly lower than that in group Ⅰ [（14.57 ±5.20）% vs. （20.45 ±5.18）% ,P 〈0.05]. Conclusion Autologous BMMCs transplantation during CABG is safe and feasible, which can reduce the myocardial infarct size in patients with myocardial infarction.

关 键 词：骨髓 细胞移植 心肌梗死 单个核细胞 

分 类 号：R542.22[医药卫生—心血管疾病]