心肌梗死后骨髓间充质干细胞治疗改进心功能及心肺复苏结果的研究_医学论文.docVIP

心肌梗死后骨髓间充质干细胞治疗改进心功能及心肺复苏结果的研究_医学论文 心肌梗死后骨髓间充质干细胞治疗改进心功能及心肺复苏结果的研究_医学论文 作者：王彤, 黄子通, 符岳, 方向韶【摘要】 【目的】　探索大鼠心肌梗死并经骨髓间充质干细胞（MSC）治疗后，心功能的变化及对其后进行的心肺复苏结果的影响。【方法】　18只雄性 Sprague-Dawley大鼠，随机分为两组，MSC 注射组和磷酸缓冲液（PBS）注射组，每组9只大鼠。先开胸结扎左前降支冠状动脉，4周后再次开胸接受PKH26荧光标记的悬浮在PBS中的5×106 MSC或仅用PBS梗死部位注射治疗，注射后2周及4周用超声心动图测量射血分数，4周时诱导心室颤动及进行心肺复苏，测量心肺复苏前及心肺复苏后4 h内的血液动力学参数的变化。并在心肺复苏72 h 后取心肌组织进行病理切片检查。【结果】　与注射磷酸缓冲液相比，注射MSC 2周（67%±4% vs 56%±5%，P＜ 0.001）及4周后（67%±6% vs 53±13%，P＜ 0.01）射血分数明显提高，心肺复苏前后的血液动力学参数包括心脏指数、dp/dt40、-dp/dt、左心室舒张末期压明显改善；虽然2组的复苏成功率没有明显区别，但72 h生存率2组比较有明显差异（58.6±20.6 vs 26.1±21.6，P＜ 0.05）。心肌组织病理切片发现有大量的PKH26标记的细胞存在。【结论】　心肌梗死后MSC治疗能明显改善心功能，同时也能明显改善心肺复苏前后的血流动力学参数及72 h生存时间。 【关键词】 骨髓间充质干细胞； 心室颤动； 心跳骤停； 心肺复苏； 心肌梗死； 射血分数； 心功能 Abstract: 【Objective】 To investigate myocardial function and outcome of cardiopulmonary resuscitation (CPR) in a rat model of myocardial infarction treated with bone marrow mesenchymal stem cells. 【Methods】 A thoracotomy was performed in 18 rats. Myocardial ischemia was induced by ligation of the left anterior descending artery (LAD). 4 weeks later, animals were randomized to receive 5×106 MSCs marked with PKH26 in phosphate buffer solution (PBS) or PBS alone as a placebo. Four weeks after MSCs or PBS injection, ventricular fibrillation (VF) and CPR were performed. Ejection fraction (EF) was quantitated two and four weeks after administrating MSCs or PBS. Hemodynamics, including cardiac index （CI）, dp/dt40, –dp/dt, and LVDP were measured before inducing VF and hourly following return of spontaneous circulation (ROSC). MSCs were counted in 5 ?滋m sections obtained from each harvested heart with cryostat. 【Results】 Significant improvements in EF, CI，dp/dt40，-dp/dt，LVDP followed injection of MSCs prior to inducing VF. Following ROSC, myocardial function and hemodynamic were significantly greater in animals treated with MSCs. Duration of survival were significantly longer in MSCs-treated animals compared PBS-treated animals. 【Conclusion】 Myocardial function before and a