【摘要】 目的研究自体骨髓干细胞经冠脉移植对心肌梗死患者心功能的影响及其安全性。方法24例冠心病伴心肌梗死患者,男20例,女4例,平均60岁(27～79岁),体外分离培养自体骨髓干细胞2～3周,开通梗死相关罪犯血管,通过冠脉转运将骨髓干细胞植入患者的心肌梗死区,移植的骨髓间充质干细胞数为(0.9～3.5)×106,骨髓单个核细胞数为(1.6～8.3)×106。术前和术后6个月分别行99mTcMIBI心肌灌注显像、二维超声心动图和动态心电图检查。结果2例患者因罪犯血管狭窄小于50%未行PCI,仅移植干细胞,1例患者因严重的冠状动脉三支血管病变未能行PCI而仅行干细胞移植,另l例患者行PCI术后,心功能仍无明显改善,半年后移植干细胞。其余20例患者在梗死相关动脉开通后注入细胞。24例患者二维超声心动图检查示LVEF较术前明显增加[51.13±9.68)vs.(42.58±12.49),P<0.05],LVDd较术前稍减少[(58.21±7.75)vs。(58.25±8.31),P>0.05],但未达统计学意义;16例99mTcMIBI检查显示梗死部位心肌灌流明显改善。术中及术后随访6～23个月无心律失常和其他合并症发生。结论进行自体骨髓干细胞经冠脉移植治疗冠心病、心肌梗死具有抑制左室重构,改善心脏功能的作用。随访6～23个月未见心律失常。更多还原

【Abstract】 Objective To evaluate the efficacy and safety of transplantation of autologous bone marrow mesenchymal stem cell (BMSCs) and mononuclear cells(BMMNCs) for treating coronary heart disease. Methods Twenty four patients,suffered from coronary heart disease with myocardial infarction, were enrolled. Autologous BMSCs+BMMNCs were isolated and cultured for 2 to 3 weeks. BMSCs(0.9～3.5)×10~6 and BMMNCs(1.6～8.3)×10~6 were transplanted through the coronary artery. Cardiac functions were determined by 2-D echocardiography, technetium-99m methoxyisobutylisonitrile (~ 99mTc -MIBI ) and ECG Holter monitor before and at 6 months after the trans plantation. Results Left ventricular ejection fraction(LVEF) was significantly increased[(51.13±9.68) vs (42.58±12.49) ,P<0.05] and left ventricular diastolic diameter(LVDd) reduced [(58.21±7.75) vs (58.25±8.31),P>0.05],There were no obvious arrhythmia or other complication was observed at 6 to 23 months follow up in 24 patients . Conclusion In patients suffered from coronary heart disease complicated with myocardiac infarction, transplantation of BMSCs+BMMNCs could improve cardiac function without significant complications and arrhythmia at 6 to 23 months follow-up.更多还原