采用OTW球囊经冠状静脉逆行灌注骨髓间充质干细胞的安全性和有效性  

Selective retrograde coronary venous perfusion of mesenchymal stem cells with over-the-wire balloon catheter： evaluation of safety and efficacy

作　　者：甄雷[1] 王晓[1] 缪黄泰[1] 乔世斌[1,3] 吴星欣[1] 乔岩[2] 刘百球[2] 刘新民[2] 阙斌[1] 聂绍平[1] 

机构地区：[1]首都医科大学附属北京安贞医院急诊危重症中心,北京市心肺血管疾病研究所,北京市100029 [2]首都医科大学附属北京安贞医院心内科 [3]山东省日照市人民医院心内一科

出　　处：《中国心血管病研究》2013年第6期451-454,I0001,共5页Chinese Journal of Cardiovascular Research

基　　金：国家自然科学基金面上项目（项目编号：81070166和81270284）;北京市教育委员会科技发展计划面上项目（项目编号：KM201010025020）

摘　　要：目的探讨采用over-the-wire（0Tw）球囊经冠状静脉逆行灌注骨髓间充质干细胞（MSCs）的安全性及有效性。方法杂种犬12只，体重（23．0±1．9）kg，采用开胸直视下完全结扎前降支（LAD）中段建立急性心梗模型。1周后采用OTW球囊将1×10^8EGFP标记的MSCs灌注到与LAD平行的前室间静脉（AIV）中段。所有实验动物分别在灌注后1h（n=4）、14d（n=4）、28d（n=4）取材，比较LAD结扎部位缺血心肌和LCX区域非缺血心肌组织中EGFP阳性细胞的数量。结果经冠状静脉逆行灌注成功率为100％（12／12），术中及术后未发生死亡、心包填塞及恶性心律失常。免疫荧光结果显示，所有时间点LAD区域内EGFP阳性细胞数均明显高于LCX区域（均P〈0．05），细胞在LAD区域内的分布也更均匀。结论采用OTW球囊经冠状静脉逆行灌注MSCs安全可行，靶向性高，细胞在缺血心肌内的分布也较为均匀、持久。Objective To evaluate the safety and efficacy of stem cell delivery via coronary venous sys- tem using over-the-wire （OTW） balloon catheter in a canine myocardial infarct model. Methods Acute myocar- dial infarction was induced by ligation of the left anterior descending （LAD） coronary artery in 12 dogs （23.0±1.9）kg. One week later, the coronary sinus was cannulated and an OTW balloon catheter was advanced to the mid- portion of anterior interventricular vein（AIV ） which is parallel to LAD. The balloon catheter was inflated temporari- ly to occlude the AIV, and 1 x l0s enhanced green fluorescence protein （EGFP）-labeled mesenchymal stem ceils （MSCs） were injected into the AIV. Animals were sacrificed at 1 hour（n=4） day 14（n=4）, and day 28（n=4） af- ter delivery and the hearts were excised and examined. Results Cell delivery by retrograde coronary venous per- fusion was successful in 100% （12/12） of the animals. There was no death, cardiac tamponade, or sustained ar- rhythmia during the procedure or the follow-up periods. The average number of EGFP-positive cells was dramati- cally higher in the LAD territory than in the remote left circumflex territory at each timepoint （all P〈0.05）. No- tably, a more homogeneous distribution of EGFP-positive cells was observed in all myocardial layers of the LAD region. Conclusion Regional cell delivery through coronary venous system with OTW balloon catheter is feasible.Infusion of MSCs via the coronary veins can provide selective, homogeneous, and persistent cell dissemination in the ischemic heart.

关 键 词：前室间静脉 细胞移植 冠状静脉逆行灌注 骨髓间充质干细胞 Over—the—wire球囊 

分 类 号：Q95-33[生物学—动物学] R541.4[医药卫生—心血管疾病]