脐带间充质干细胞治疗对老年陈旧性心肌梗死患者肝X受体α和可溶性CD40配体的影响  

Effects of human umbilical cord mesenchymal stem cells therapy on LXRα and sCD40L in elderly patients with old myocardial infarction

作　　者：陈颖[1] 胡有东[1] 郭燕[1] 郭殿选[1] 李侠[1] 

机构地区：[1]徐州医学院附属淮安医院老年病科,223002

出　　处：《中华损伤与修复杂志（电子版）》2014年第3期44-48,共5页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

基　　金：江苏省卫生国际交流支撑计划项目(JSWSGJ2012366);江苏省高校自然科学研究计划项目(KJD310234);江苏省淮安市科技项目(HAS04020)

摘　　要：目的探讨人脐带间充质干细胞(hUC-MSCs)治疗老年人陈旧性心肌梗死对肝X受体α(LXRα)和可溶性CD40配体(sCD40L)的影响。方法选择2010年7月至2012年8月徐州医学院附属淮安医院老年病科入住的陈旧性心肌梗死合并心力衰竭患者30例。其中15例接受冠脉介入术(PCI)+支架植入术(对照组),平均(78.9±6.2)岁;另外15例接受PCI+支架植入术+hUC-MSCs(试验组),平均(79.2±6.9)岁。采用磁共振成像(MRI)和单光子发射计算机断层成像术(SPECT)测定两组患者术前、术后4周、术后8周心肌梗死面积;使用MRI、SPECT和彩色多普勒超声(CDU)显像仪测定患者术前、术后4周、术后8周左心室射血分数(LVEF);使用CDU显像仪按照Gimelli检测方法测定LVEF;采用酶联免疫吸附双抗体夹心法(ELISA)法检测对照组和试验组患者的外周血LXRα和sCD40L表达水平与心肌梗死面积和LVEF的关系。结果随着血管闭塞程度的加重,LXRα水平下降,sCD40L水平升高;采用SPECT检测对照组与试验组术后8周梗死面积分别为(26.6±3.4)%、(24.2±3.9)%,两组比较差异有统计学意义(t=49.19,P<0.05);采用彩色多普勒超声(CDU)显像术检测对照组与试验组术后8周LVEF分别为(38.4±2.8)%、(46.1±1.9)%,两组比较差异有统计学意义(P<0.05);对照组治疗后后8周LXRα(4.2±1.1)μg/mL、sCD40L(7.1±2.0)μg/L;试验组移植后8周LXRα(7.7±1.8)μg/mL,sCD40L(3.1±1.2)μg/L,两组比较,差异有统计学意义(t=85.91、98.81,P均<0.05)。结论 LXRα和sCD40L表达水平变化与hUCM-SCs移植患者梗死面积的缩小和LVEF的改善相关。Objective To study the effects of human umbilical cord mesenchymal stem cells （ hUC- MSCs） therapy on peripheral blood LXRα and sCD40L in elderly patients with old myocardial infarction. Methods The study was conducted between July 2010 and August 2012 from the Affiliated Huai＇ an Hospital of Xuzhou Medical College. Patients with old myocardial infarction and heart failure were divided into the control group （ n = 15, mean age 78.9 ± 6.2） treated with percutaneous coronary intervention （PCI） and stent implantation） and the experimental group （ n = 15, mean age 79.2 ± 6.9, treated with PCI, stent implantation and hUC-MSCs transplantation ）. Using magnetic resonance imaging （MRI） and single photonemission-computed tomography （SPECT） were measured in two groups of patients before and after 4 week, 8 weeks after the operation, the area of myocardial infarction ; the use of MRI, ECT and CDU imaging determination of patients before surgery, 4 week, 8 weeks after the operation, LVEF ; Determination of LVEF with Gimelli detection methods using CDU imaging. The expression levels of peripheral blood LXRα and sCD40L were measured by ELISA. The correlation between the levels of LXRα and sCD40L and the infarct size,left ventricular ejection fraction（LVEF） were evaluated. Results With the decline in the level of LXR α increased the degree of vascular occlusion, elevated levels of sCD40L. After 8 weeks of treatment, there were significant differences in infarct size using SPECT, the control group and the experimental group [ （26.6 ± 3.4 ） % vs （ 24. 2 ± 3.9 ） % t = 49. 19, P 〈 0.05 ] ; CDU imaging detection control group and experimental group after 8 weeks of LVEF were （38.4 ± 2.8）%, （46. 1 ± 1.9）%, the difference between the two groups with statistical significance （ P 〈 0.05 ） The LXRα level was significantly higher in the experimental group than in the control group [ （4.2 ± 1.1 ）μg/mL vs （7.7 ± 1.8 ） μg/mL, P 〈 0.05 ]. The level of sCD40L was

关 键 词：脐带 间充质干细胞 老年人 心肌梗死 肝细胞 受体Α CD40配体 

分 类 号：R542.22[医药卫生—心血管疾病]