【摘要】 目的:观察在行冠状动脉搭桥术(CABG)同期通过桥血管注入自体骨髓单个核细胞(BMMC)对治疗缺血性心脏病的可行性、安全性及疗效。方法:选择60例缺血性心脏病患者,征得患者同意,分为对照组和细胞移植组,每组30例。自体BMMC于术中劈开胸骨后采集胸骨骨髓,经Ficoll密度梯度离心法分离获得。对照组予以CABG,术中经桥血管注入生理盐水12mL;细胞移植组予以CABG+经桥血管注入自体BMMC12mL。2组患者分别于术前、术后6个月进行心功能评价、多普勒超声心动图、心肌放射性核素断层扫描(SPECT)检查,记录术后6个月内主要心血管事件发生情况。结果:术后随访6个月,2组患者均无恶性心律失常和其他严重并发症发生。术后6个月时,2组患者NYHA分级均较术前改善(t=12.794、16.155,P均<0.05),细胞移植组NYHA分级较对照组提升(t=4.109,P<0.05),左室舒张末期内径(55.6±3.0)mm较对照组(60.2±2.8)mm减小(t=6.12,P<0.05),左室射血分数(53.4±5.1)%较对照组(50.3±6.2)%上升(t=2.15,P<0.05),心肌缺血梗死面积(19.1±85.5)%较对照组(24.8±12.3)%减小(t=2.10,P<0.05)。结论:CABG同期行自体BMMC移植治疗心肌梗死安全有效,并能够在CABG恢复心肌血运的基础上缩小心肌缺血梗死面积,改善心功能。更多还原

【Abstract】 Aim:To investigate the feasibility,safety,clinical effect,and kickbacks of injecting autologous bone marrow mononuclear cells(BMMC) into coronary artery to treat ischemic heart disease(IHD) while undergoing coronary artery bypass grafting(CABG) and its mechanisms.Methods:60 IHD patients were randomly assigned CABG alone(control) or CABG with intracoronary administration of BMMC(n=30) group.The BMMC were obtained during the operation.Baseline and follow up evaluations included Doppler echocardiogram and single photon Emission Computed tomography of heart before and 6 months after operation.Results:Neither vicious arrhythmia nor other complication was observed during 6 months follow up in all patients.After 6 months,LVEDD in control group and transplanting group were(60.2±2.8) mm and(55.6±3.0) mm,there were significant differences(t=6.12,P<0.05).LVEF in control group and transplanting group were(50.3±6.2)% and(53.4±5.1)%,there were significant differences(t=2.15,P<0.05).The area of myocardial infarction in control group significantly less than that in the transplanting group [(0.248±0.123 vs.(0.191±0.855),t=2.10,P<0.05].Conclusion:CABG combined with autologous BMMC transplantation in the treatment of IHD is feasible and safe,and improve the heart function.更多还原