自体外周血干细胞移植治疗心肌梗死  

Clinical Study on Autologous Peripheral Blood Stem Cells Transplantation for Myocardial infarction

作　　者：李强[1] 刘艳超[1] 崔剑颖[2] 刘超[3] 孟自力[1] 池菲[4] 刘永辉[1] LI Qiang LIU Yan-chao CUI Jian-ying LIU Chao MENG Zi-li CHI Fei LIU Yong-hui(Dept. of Cardiac Surgery Clinic College of Hebei Medical Uninersity Dept. of Cardiology Dept. of Emergency, The Chest Hosipital of Hebei Province, Shijiazhuang Hebei 050041, China)

机构地区：[1]河北省胸科医院心脏外科 [2]河北医科大学临床学院 [3]河北省胸科医院心内科,河北石家庄050041 [4]河北省胸科医院急诊科,河北石家庄050041

出　　处：《昆明医科大学学报》2016年第7期103-106,共4页Journal of Kunming Medical University

基　　金：河北省医学科学研究重点课题计划(20120237)

摘　　要：目的探讨冠状动脉旁路移植术(coronary artery bypass grafting,CABG)同期经冠状动脉移植血管及心脏外膜注射自体外周血干细胞对心肌梗死患者心功能的影响及其近期临床疗效.方法自2012年1月至2015年1月共入选心梗死患者76例,根据是否行自体外周血干细胞移植分为移植组(46例)和对照组(30例).心梗患者入院后在常规药物治疗基础上,移植组CABG前5d动员及扩增自体外周血干细胞,CABG前24h采集自体外周血干细胞.76例患者均行非体外循环心脏不停跳冠状动脉旁路移植术,移植组在完成冠状动脉旁路血管吻合后,经移植血管及心脏外膜注射自体外周血干细胞,而对照组不注射自体外周血干细胞.运用超声心动图评价术前及术后6个月患者左室形态、室壁节段运动指数(wall motion score index,WMSI)及心功能指标.结果术后6个月时,2组患者左心室舒张末期内径减小,左心室射血分数均有增高,WMSI降低,差异均有统计学意义(P<0.05).组间比较,移植组术后各项心功能指标优于对照组患者(P<0.05).结论冠状动脉旁路移植同期,自体外周血干细胞移植能显著改善心肌梗死患者心功能,近期临床疗效明显.Objective To study the clinical efficacy of autologous peripheral blood stem cell transplantation for the treatment myocardial infarction, in the same period of coronary artery bypass grafting （CABG） . Methods From January 2012 to January 2015, 76 patients with myocardial infarction were selected. Patients were divided into transplantation group （n =46） and control group （n =30） on the basis of whether being treated by autologous peripheral blood stem cell transplantation. After myocardial infarction patients were taken to the hospital with the therapy of conventional drug, 5 days before CABG, transplantation group was given the autologous peripheral blood stem cell mobilization and expansion, 24 hours before CABG, taking autologous peripheral blood stem cell collection. 76 patients took CABG with non-cardiopulmonary by pass, transplantation group was given autologous peripheral blood stem cell via transplantation vessels and subepicardial, while the control group was not given the injection of autologous peripheral blood stem cell. The LV morphology, wall motion score index （WMSI） and index of cardiac function before and after the operation in both groups were evaluated by echocardiography. Results Six months after CABG, there was a significant decrease in Left ventricular end-diastolic diameter and wall motion score index, Left ventricular ejection fraction was increased. The indexes of cardiac function in the transplantation group were better than the control group. Conclusion Autologous peripheral blood stem cell transplantation for the treatment myocardial infarction can improve the heart function, and has obvious recent clinical curative effect in the same period of CABG.

关 键 词：冠状动脉旁路移植术 心肌梗死 干细胞 移植 

分 类 号：R619.9[医药卫生—外科学]