脐带间充质干细胞与脐血CD34＋细胞联合移植治疗心肌梗死  

Cotransplantation of umbilical cord mesenchymal stem cells and umbilical cord blood CD34＋ cells for the treatment of myocardial infarction

作　　者：马群兴 李彤[1] 赵越[1] 张强[1] 吴鹏[1] 王东[1] 朱争艳[1] 高英堂[1] 

机构地区：[1]300170天津市第三中心医院心脏中心

出　　处：《中华胸心血管外科杂志》2014年第2期82-85,89,共5页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的探讨脐带间充质干细胞（UC—MSCs）与脐血CD34＋（UCB—CD34＋）细胞联合移植对心肌梗死（MI）后心功能的影响。方法成年雌性日本大耳白兔17只，联合移植组和对照组各8只，1只取正常心脏。开胸结扎左心室支（LVB）建立心肌梗死模型，从脐带和脐血中分别分离间充质干细胞（MSCs）和CD34＋细胞，于建模后4周二次开胸进行细胞联合移植，单纯磷酸盐缓冲液（PBS）移植作为对照。建模前、后4周及移植后4周行心脏超声心动检查左心室缩短分数（LVFS）变化，处死兔子留取心脏标本，行HE、Masson染色观察心肌纤维化程度，行免疫组织化学染色观察梗死周边血管形成和细胞分化情况。结果两组兔子基线数据差异无统计学意义。建模后两组LVFS差异无统计学意义[（31．63±2．20）％对（32．75±1．16）％，P〉0．05]；移植后4周，对照组中LVFS较建模后下降[（32．00±0．76）％对（32．75±1．16）％，P〈0．05]，联合移植组中较建模后升高140．13±2．48）％对（31．63±2．20）％，P〈0．01]。移植后4周，联合移植组的LVFS显著高于对照组[（40．13±2．48）％对（32．00±0．76）％，P〈0．01]。HE、Masson染色示梗死区大量心肌细胞坏死，代之以胶原纤维，且联合移植组胶原含量较对照组少；免疫组织化学染色示联合移植组梗死区域可见cTnI（＋）及CD31（＋）的细胞管状结构，对照组未见阳性细胞存在。结论UC—MSCs和CD34＋细胞联合移植可改善心肌梗死后心功能，可能与梗死周边微血管和心肌细胞形成有关。Objective To investigate the effect of cotransplantation of umbilical cord mesenchymal stem cells （UC-MSCs） and umbilical cord blood CD34＋ （UCB-CD34 ＋ ） cells on the heart function after myocardial infarction. Methods Ligating the left ventrieular branch（LVB） after median sternotomy to establish a model of myocardial infarction using 17 adult female Japanese white rabbits,dividing into cotransplantation group and PBS group（8 per group） ,and one is killed for the normal heart. Electrocardiogram （ECG） is measured before and after ligation of LVB and four weeks after ligation. Isolate MSCs from umbilical cord and CD34＋ cells from human umbilical cord blood, respectively. Four weeks after the establishment of the model, cotransplantation is administered, and transplantation of PBS alone is as control. Ultrasonic cardiogram is given before and four weeks after the establishment of the model and four weeks after transplantation, and then rabbits are sacrificed. The hearts are taken and cut into slices for HE and Massong trichrome staining to evaluate the degree of myocardial fibrosis, and immunohistochemieal staining to evaluate neovascularization and transdifferentiation in the infarcted area. Results The baseline datas between two groups are not different. And Left ventricular fraction shortening （LVFS） after the establishment of the model have no significant difference between two groups [ （31.63 ± 2.20 ） % vs （ 32.75 ± 1.16） %, P 〉 0.05 ]. LVFS after transplantation decreased compared with LVFS before transplantation in control group [ 32.00 ± 0.76） % VS （ 32.75 ± 1.16 ） %, P 〈 0.05], but increased in eotransplantation group [（40.13 ± 2.48 ） % vs （ 31.63 ± 2.20 ） %, P 〈 0.011. After transplantation, LVFS of the cotransplantation group is higher than that of the control group, [ （40.13±2.48 ） % vs （32.00 ± 0.76） %, P 〈 0.011. As is shown by HE and Masson g trichrome staining, many cardiomyocytes are necrotic and replaced by collagenous fiber

关 键 词：心肌梗死 间质干细胞移植 脐血干细胞移植 

分 类 号：R542.22[医药卫生—心血管疾病]