【摘要】 目的 用双源CT冠状动脉CT血管造影(DSCT-CCTA)评价猪急性心肌梗死后诱导性多能干细胞(iPSc)移植对左心室心功能变化的影响。方法 将18只猪随机分入对照组、心肌梗死(AMI)组和iPSc移植组,每组6只。术后1周及6周分别应用DSCT-CCTA技术观察左心功能改变情况,检测其左心室舒张末期容积(LVEDV)、收缩末期容积(LVESV)和左室射血分数(LVEF),比较每组内前后变化及3组间差异;术后6周处死动物,取心脏标本行TTC染色和HE染色。结果 术后1周心肌梗死组及iPSc移植组较对照组LVEF降低(P<0.000 1),LVESV及LVEDV变化不大;术后6周心肌梗死组较对照组LVESV增加(P=0.010),LVEF降低(P<0.001),iPSc移植组较心肌梗死组LVEF升高(P=0.003);术后6周和1周相比心肌梗死组LVESV、LVEDV均增加(t=3.86,P=0.012;t=2.96,P=0.031),LVEF未见明显变化,iPSc移植组左心室LVEDV及LVEF均增加(t=11.91,P=0.000;t=3.14,P=0.026),LVESV未见明显差异。结论 急性心肌梗死iPSc移植6周后心功能明显改善,梗死面积有所减小。用DSCT-CCTA技术可以评价AMI后左心室重构过程及iPSc移植对左心功能的影响,对临床治疗及预后评价具有重要指导意义。更多还原

【Abstract】 Objective To estimate the imact of being implanted induced pluripotent stem cells(iPSc) on the left ventricular function of acute myocardial infarction(AMI) swine model by using dual source CT-coronary artery CT angiography(DSCT-CCTA).Methods Eighteen swine were randomly equally divided into control group,AMI group and iPSc group.The left heart function of 3 groups was assessed by DSCT at 1 and 6 weeks after operation,respectively,including the left ventricular end-systolic volume(LVESV),left ventricular end-diastolic volume(LVEDV) and left ventricular ejection fraction(LVEF).Surviving iPSc in infarcted myocardium were identified by triphenyltetrazolium chloride(TTC) stain and hematoxylin and eosin(HE) stain 6 weeks after the transplantation.Results Comparing with the control group,LVEF decreased(P<0.000 1) in the AMI group and iPSc group 1 week after operation.Six weeks later,the AMI group showed increased LVESV(P=0.010) and decreased LVEF(P<0.001) in relative to the control group,while,the iPSc group showed increased LVFF(P=0.003) compared with AMI group.The AMI group showed increased LVESV and LVEDV(t=3.86,P=0.012;t=2.96,P=0.031) 6 weeks after operation compared with the first week’s result but the LVEF showed no significant difference.The iPSc group showed increased LVEDV and LVEF(t=11.91,P=0.000;t=(3.14,P=0.026),but the LVESV showed no significant difference 6 weeks after operation with the first week ’ s result.Conclusion Implantation of iPSc into the infracted myocardium might decrease the infarction area and improve cardiac function 6 weeks after the implantation.DSCT-CCTA can be used to evaluateg left ventricular remodeling after acute myocardial infarction and the impact on the cardiac function of the implantation of iPSc,and contribute to the clinical treatment and prognosis.更多还原