实时三维超声心动图评价人重组粒细胞集落刺激因子治疗急性心肌梗死后左心功能及心室重构  

Value of real time three-dimensional echocardiography in the evaluation of left ventricular function and remodeling after rhG-CSF treatment in patients with acute myocardial infarction

作　　者：杨春[1,2] 邓争荣 朱雯瑾 张涛[1,2] 韩克[1,2] 马爱群[1,2] 

机构地区：[1]西安交通大学医学院第一附属医院心内科 [2]西安交通大学医学院教育部环境与疾病相关基因重点实验室,西安710061

出　　处：《山西医科大学学报》2012年第1期7-10,共4页Journal of Shanxi Medical University

基　　金：国家自然科学基金重点资助项目(30830051)

摘　　要：目的应用实时三维超声心动图(RT3DE)观察早期运用人重组粒细胞集落刺激因子(rhG-CSF)治疗急性心肌梗死对左心功能及心室重构影响。方法选择30例急性心肌梗死患者,入院时间为症状出现12 h以上,均未行早期血运重建治疗,随机分为G-CSF组(n=15)和对照组(n=15)。G-CSF组急性心肌梗死24 h内皮下注射rhG-CSF,10μg/kg,连续7 d;对照组给予同等剂量生理盐水。rhG-CSF治疗后1周和随访12,24个月行RT3DE检查评价左室射血分数(LVEF)及左室舒张末容积(LVEDV)。结果 rhG-CSF治疗后1周,两组间LVEF及LVEDV比较差异无统计学意义。G-CSF组随访12,24个月LVEF较rhG-CSF治疗后1周显著升高(P<0.05),LVEDV虽有扩大,但与rhG-CSF治疗后1周比较差异无统计学意义(P>0.05)。与rhG-CSF治疗后1周比较,对照组随访12,24个月后LVEF无显著改变(P>0.05),LVEDV显著扩大(P<0.05)。与对照组比较,随访12,24月G-CSF组LVEF显著升高(P<0.05),LVEDV显著降低(P<0.05)。结论急性心肌梗死后对于未能进行早期血运重建的患者早期使用G-CSF动员骨髓干细胞,可改善左室射血功能,抑制心室重构。Objective To explore the effect of real time-three dimensional echocardiography（RT3DE） in the evaluation of left ventricular function and remodeling after early treatment with recombinant human granulocyte colony stimulating factor（rhG-CSF） in patients with acute myocardial infarction（AMI）.Methods Thirty patients with AMI who arrived at hospital 12 h after symptom onset were randomized into G-CSF group and control group.All patients did not receive the early revascularization therapy.The patients were given rhG-CSF 10 μg/kg and saline for 7 d in 2 groups,respectively.RT3DE was performed at 1 week after rhG-CSF treatment and repeated after followed up for 12 and 24 months.Results There was no statistically difference between 2 groups in left ventricular ejection fraction（LVEF）and left ventricular end-diastolic volume（LVEDV）at 1 week after rhG-CSF treatment.Compared with that at 1 week after rhG-CSF treatment,LVEF was increased significantly after followed up for 12 and 24 months in G-CSF group（P0.05）,but there was no significant change in LVEDV（P0.05）.Compared with that at 1 week after rhG-CSF treatment,there was no significant change in LVEF after followed up for 12 and 24 months in control group（P0.05）,however,LVEDV was increased significantly（P0.05）.Compared with control group,LVEF was significantly increased（P0.05）and LVEDV was significantly decresaed after followed up for 12 and 24 months in G-CSF group（P0.05）.Conclusion Early mobilization of bone marrow stem cells induced by G-CSF may improve the ventricular ejection and prevent the ventricular remodeling in patients who do not undergo the early reperfusion therapy after AMI.

关 键 词：急性心肌梗死 实时三维超声心动图 骨髓干细胞 粒细胞集落刺激因子 心室重构 

分 类 号：R542.22[医药卫生—心血管疾病]