脐血干细胞移植对严重冠心病患者左心室重塑的改善作用  

Transplantation of umbilicalcord blood stem cell attenuated left ventricular remodeling in severe coronary artery disease patients

作　　者：蒋智[1] 贾中申 韦方[1,2] 李安杰[1] 周永刚[1] 梁青龙[1] 周松[1] 

机构地区：[1]贵州省人民医院心内科,贵州贵阳550002 [2]贵州医科大学,贵州贵阳550004

出　　处：《贵州医药》2016年第2期115-118,共4页Guizhou Medical Journal

基　　金：国家自然科学基金地区科学基金[81460050];贵州省科技厅贵州省人民医院联合基金[黔科合LS字(2011)014];贵州省科技厅科学技术基金[黔科合J字(2014)2112号];贵州省卫计委科学技术基金[gzwkj2013-1-006]

摘　　要：目的研究异体脐带血干细胞(UCBSC)移植对严重冠心病患者左心室重塑的作用。方法将40例冠状动脉造影为三支血管弥漫病变的冠心病患者随机分为对照组和UCBSC组,均给予常规内科药物治疗,UCBSC组在此基础上经冠状动脉前降支移植UCBSCs。移植前、移植后48h、4周、12周分别检测血清Ⅰ型前胶原羧基端肽(PICP)、Ⅲ型前胶原氨基末端前肽(PCⅢNP)和血管内皮生长因子(VEGF)水平,用心脏超声检测左室舒张末期内径(LVEDd)、左室收缩末期内径(LVESd)和左室射血分数(LVEF)值。结果 UCBSC组患者均未发现过敏反应及移植相关不良反应。与对照组及移植前相比,UCBSC组在移植后48h血清VEGF水平显著升高(P<0.01),血浆PICP、PCⅢNP水平降低(P<0.01),且VEGF变化与PICP、PCⅢNP呈负相关(P<0.01)。移植后12周,UCBSC组LVESd小于对照组(P<0.05),但LVEF差异无统计学意义。结论严重冠心病患者经冠脉移植异体UCBSCs安全有效,通过上调VEGF表达可抑制心脏纤维化,从而改善左室重塑。Objective To investigate the effect of intra-coronary transplantation of allogeneic umbilical cord blood stem cells（UCBSC）on left ventricular remodeling in severe coronary artery disease patients.Methods 40 diffused 3-vessel disease patients were randomly divided into control and UCBSC group.Both groups were administrated with routine medications and UCBSC group was transplanted with UCBSCs through left descending artery.Serum vascular endothelial growth factor（VEGF）,carboxy terminal propeptide of procollagen type I（PICP）,precollagen typeⅢ N-peptide（PCIIINP）was measured before,48 hours,4weeks and 12 weeks after UCBSCs transplantation.Left ventricular end diastolic diameter（LVEDd）,left ventricular end systolic diameter（LVESd）and left ventricular ejection fraction（LVEF）were evaluated with 2-D echocardiography.Results All patients in UCBSC group did not show any allergic reaction or transplantation related adverse effect.As compared with pre-transplantation and the same timepoint of control group,serum VEGF concentration increased in UCBSC group at 48h（P〈0.01）,however,PICP and PCIIINP concentrations decreased（P〈0.01）.The VEGF and the PICP or PCIIINP showed negative correlation（P〈0.01）.The LVESd were larger in control group than that in UCBSC group at 12 weeks（P〈0.05）,but the difference of LVEDd and LVEF showed no significance.ConclusionIt is safe and effective that allogeneic UCBSCs transplantation upregulated VEGF expression,reduced myocardial fibrosis and attenuated left ventricular remodeling in severe coronary artery disease patients.

关 键 词：冠心病 脐带血干细胞 异体移植 胶原 心室重塑 

分 类 号：R-33[医药卫生] R542.2