自体骨髓干细胞移植治疗心肌梗死患者心肌代谢及收缩功能的变化.docVIP

【关键词】? 干细胞;,骨髓;,干细胞移植;,心肌梗死 　　［摘 要］ 目的:? 探讨自体骨髓间充质干细胞（BMSCs）和单个核细胞（BMMNCs）经梗死相关冠状动脉（IRA）移植对冠心病心肌梗死患者近、中期心功能、心肌代谢的影响及其安全性。方法:? 对14例冠心病伴心肌梗死史1～35个月的患者。细胞移植组8例，通过冠脉系统将BMSCs和BMMNCs植入心肌梗死区，余6例常规治疗。两组患者均于术前和术后3，8个月行SPECT双核素心肌显像、二维超声心动图、6 min步行试验及动态心电图检查。结果:? 移植组患者在梗死相关冠脉开通后注入干细胞，8例心功能从～级提高至～级，6 min步行试验从（320.72±60.47）m? 提高至（406.88±68.31）m，6个月后又提高至（484.79±81.00）m。6例前壁心梗患者3，8月后LVEF由术前的42.5% 提高至49.5%和54%;术后3，8月心肌双核素检查缺损区占整个心肌体积由术前的45.5%减少至39%和? 25%。6例对照组患者术后3月EF较术前提高，心肌双核素检查缺损区占心肌体积减少，术后8月与术后3月无明显改变。2例下壁心肌梗死患者经干细胞移植临床效果不明显。结论:? 自体BMSCs和BMMNCs经冠脉移植治疗冠心病心肌梗死，可以显著改善前壁心肌梗死患者左室收缩功能和心肌代谢。??? 　　［关键词］干细胞; 骨髓; 干细胞移植; 心肌梗死 　　Impact of autologous mononuclear bone marrow cells transplantation?? on early and med-term outcomes on the cardiac function and?? myocardial metabolic in patients with myocardial infaction?? 　　ZHANG Yu-yan，DING Zhi-jian， ZHANG Fu-min， YANG Zhi-jian?? ， WANG Yin ，CHEN Jie-zhong， SUN Yong ， XU Long-bao??? 1?? ， XU Yu-hong? 　　（1.Department of Cardiology， No.2 People′s Hospital of Changzhou ，Nanjing Medical Univerty， Changzhou Jiangsu 213003;?? 2. Department of Cardiology，No.1 Affiliated Hospital of Nanjing Medical Univerty， Nanjing Jiangsu 210029， China）??? 　　　　［Abstract］ Objective: To evaluate the early and med-term outcomes of trans- plantation of autologous?? bone marrow mesenchymal stem cell（BMSCs） and monoucleus cells（ BMMNCs） for treating coronany heart?? disease. Methods: Fourteen patients who had suffered from coronary heart disease with myocardial infarc-? tion ，were enrolled in this prospective， nonrandomized ，control study （8 patients in cell transplantation?? group;6 in control group） .Autologous BMSCs+BMMNCs were transplanted into the myocardial infracted?? area in the cell transplantation group through intracoronary way.All patients underwent 3-month and 8-? month follow-up，6 minutes test， 2D Doppler echocardiogram， SPECT. Results: After 3 months and 8?? months follow-up，cardiac function were improved :6 minuts distance was prolonged from 320.72±60.