自体骨髓干细胞移植治疗急性心肌梗死临床研究  

Autologous bone marrow stem cells transplantation in treatment of acute myocardial infarction clinical research

作　　者：张奇峰[1] 钟志雄[1] 李斌[1] 李存仁[1] 张鹏飞[1] 叶卓联[1] 古献芳[1] 

机构地区：[1]梅州市人民医院心内科,广东梅州514089

出　　处：《中国医学前沿杂志（电子版）》2014年第6期33-36,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：广东省2008年科技计划项目(2008B030301273)

摘　　要：目的探讨自体骨髓干细胞移植治疗急性心肌梗死(AMI)的临床疗效。方法选取本院收治的38例AMI患者,符合世界卫生组织制定的AMI诊断标准。患者随机分为骨髓干细胞移植组18例[行经皮冠状动脉介入治疗(PCI)+干细胞移植]和对照组20例(仅行PCI)。患者均常规使用阿司匹林、氯吡格雷、阿托伐他汀、β受体阻滞剂、血管紧张素转换酶抑制剂(ACEI)等药物,合并心力衰竭患者常规使用利尿剂。移植组患者均在梗死相关血管行PCI术后进行干细胞移植。对比两组患者治疗效果。结果术后3个月、6个月评价观察组患者心功能NYHA分级和6分钟步行试验,较治疗前有显著改善(P<0.05);对照组患者心功能分级与6分钟步行试验较治疗前无显著差异(P>0.05)。经随访,两组患者左心室舒张末期内径(LVDD)与术前比较无明显变化(P>0.05)。所有患者均在术前、术后3个月和6个月行磁共振心肌显像检查,细胞移植前与移植后患者梗死区域减少,以单支血管病变患者明显。所有移植组患者术后未发现冠状动脉内血栓形成和血流缓慢或无血流现象。术后体温、血压、心律正常。结论自体骨髓干细胞移植治疗急性心肌梗死效果好,安全性高,值得推广。Objective To explore the effect of autologous bone marrow stem cells transplantation in treatment of acute myocardial infarction. Method 38 cases patients with acute myocardial infarction, and the inclusion criteria for acute myocardial infarction comply with the WHO diagnostic criteria. Patients were randomly divided into the bone marrow stem cell transplantation group （PCI＋stem cell transplant, n=18） and the control group （only PCI, n = 20）. Patients were regular use of aspirin, clopidogrel, atorvastatin, beta blockers, angiotensin converting enzyme inhibitors, such as drugs, merge the routine use of diuretics in patients with heart failure. Transplantation group were recorded in infarct related blood vessels PCI for stem cell transplantation. Compare the treatment effect. Result The observation group after 3 months, 6 months according to the clinical evaluation of cardiac function NYHA classiifcation and walking test results improved signiifcantly （P 0.05）. After follow-up,two groups of patients with left ventricular end-diastolic diameter （LVDD） no obvious change compared with the preoperative, P 〉 0.05）. All patients in preoperative, 3, 6 months after myocardial imaging, magnetic resonance before cell transplantation and transplant patients after myocardial infarction area reduced, in a single vascular lesions in patients with obvious. All transplant patients found no postoperative coronary artery thrombosis and blood stream is slow or no blood lfow phenomenon. Postoperative body temperature, blood pressure, heart rate, normal. Conclusion Autologous bone marrow stem cells transplantation in treatment of acute myocardial infarction,＆nbsp;good effect, high safety, is worth promoting.

关 键 词：自体骨髓干细胞移植 急性心肌梗死 效果 安全性 

分 类 号：R542.22[医药卫生—心血管疾病]