【摘要】 目的探讨急性心肌梗死患者自体骨髓干细胞冠状动脉内注射对改善心功能和血管内皮细胞生长因子(VEGF)的影响。方法将急性心肌梗死住院并行介入治疗的患者25例,按照随机分组的原则分为干细胞移植治疗组(10例)和对照组(15例),治疗组患者在心肌梗死发生14d后进行冠状动脉内注射自体骨髓干细胞治疗。术前1周和术后6个月时,二维超声心动图评价患者左室射血分数(EF%),术后第3、7、14、28、56天时用酶联免疫吸附法测定患者血清VEGF浓度。结果干细胞移植治疗组与对照组比较,自体骨髓干细胞移植前两组间左室射血分数差异无统计学意义(P>0.05),术后6个月时治疗组明显高于对照组(P<0.05),患者发生再梗死、再次血运重建和死亡的概率两组间差异无统计学意义(P>0.05),而心力衰竭的发生率治疗组少于对照组(P<0.05);血清VEGF浓度移植治疗组明显高于对照组(P<0.05)。结论急性心肌梗死后通过自体骨髓干细胞冠状动脉内移植能增加患者血清VEGF浓度,改善患者的心功能,减少心力衰竭的发生。更多还原

【Abstract】 Objective To investigate the effect of intracoronary transplantation of autologous bone marrow mesenchymal stem cell on left ventricular function and the vascular endothelial growth factor (VEGF) in patients with acute myocardial infarction.Methods After successful percutaneous coronary intervention (PCI) for acute myocardial infarction,25 patients were randomly assigned to either a control group (n = 15) that received optimum postinfarction medical treatment,or a bone-marrow-cell group (n = 10) that received optimum medical treatment and intracoronary transfer of autologous bone-marrow cells 14 days after PCI.Data about left ventricular ejection fraction (LVEF) were obtained by echocardiogram before and at 6 months’ follow-up.The serum levels of VEGF were measured by ELISA at 3-day,7-day,14-day,28-day,56-day time-points after transplatation,respectively.Results There was no significant difference between the two groups in LVEF before intracoronary transplantation of autologous bone marrow stem cell (P > 0.05).After 6 months,LVEF in treated patients was improved significantly (P < 0.05) compared with the control,though there was no significant difference in the rate of re-infarction,re-myocardial perfusion and death.The serum levels of VEGF in patients accepted transplation were significantly higher than the levels in control patients (P < 0.05).Conclusion After intracoronary transplantation of autologous bone marrow stem cell in patients with acute myocardial infarction,the left ventricular function could be improved and the heart failure be decreased by the way to increase serum level of VEGF.更多还原