【摘要】 目的:探讨对照研究自体骨髓单个核细胞(BM-MNC s)冠脉内移植治疗急性与陈旧性心肌梗死的临床疗效。方法:选择35例NYHA心功能分级Ⅱ~Ⅲ级行择期介入治疗术的心肌梗死患者,急性心梗患者20例,陈旧性心梗患者15例。两组患者在介入治疗术结束后均通过大腔导管于梗死相关血管注入BM-MNC s。用流式细胞仪对BM-MNC s进行细胞计数及成分鉴定;术前、术后45d、90d行静息T e99m SPECT检查进行疗效判断。结果:①用F ico ll密度梯度离心法获得单个核细胞1.7×108~5.7×108(3.6±1.7×108)个,细胞活性均大于92%;CD 34+细胞2.56%±0.98%,AC 133+细胞0.56%±0.23%。②急性心梗组术前、术后45d、90d静息T e99m SPECT心肌灌注缺损区面积占总面积百分比分别为25.11%±7.26%、17.89%±5.49%、15.19%±3.95%(P<0.05);陈旧性心梗组术前、术后45d、术后90d静息T e99m SPECT心肌灌注缺损区面积占总面积百分比分别为25.28%±7.38%、21.12%±6.82%、18.86%±6.41%(P<0.05)。急性心梗组与陈旧性心梗组术后45dSPECT灌注缺损区面积较术前分别缩小28.75%和16.46%(P<0.05);急性心梗组与陈旧性心梗组术后90d SPECT灌注缺损区面积较术后45d分别缩小15.09%和10.70%(P<0.05)。结论:自体骨髓单个核细胞梗死相关冠脉内移植治疗急性心肌梗死与陈旧性心梗均有一定的疗效,但对急性心梗的疗效优于陈旧性心梗。更多还原

【Abstract】 Objective:To assess the efficacy of autologous bone marrow mononuclear cells transplantation by intracoronary infusion in patients with AMI or OMI.Methods:We studied 35 patients who underwent percutaneous coronary intervention(PCI) after AMI or OMI with NYHAⅡ～Ⅲ class.In thirty-five patients,20 patients who had AMI history and 15patients who had OMI history,autologous bone marrow mononuclear cells(BM-MNCs)was infused into the infarct related artery(IRA) through the guiding catheter after PCI in both groups.Cells were counted by flow cytometer(FCM).SPECT were assessed pre-PCI and at 45d,90d follow-up in all patients.Results :①BM-MNCs was harvested by Ficoll density separation.1.7×10~8～5.7×10~8(3.6±1.7×10~8) BM-MNCs were harvested;this consisted of 2.56%±0.98% CD34+ cells and 0.56%±0.23% AC133+ cells.Activity was more than 92%.② SPECT scan results showed that perfusion defect was decreased from 25.11%±7.26% to 17.89%±5.49%,15.19%±3.95%(P<0.05)in AMI group and from 25.28%±7.38% to 21.12%±6.82%,18.86%±6.41% by(P<0.05)in OMI group at 45d and 90d follow-up respectively.The perfusion defect was decreased by 28.75% and 16.46% at 45d compared base-line in and OMI group respectively(P<0.05).The perfusion defect was decreased by 15.09% and 10.70% at 90d with 45d follow-up in AMI and OMI group respectively(P<0.05).Conclusions: BM-MNCs transplantation has someefficacy in patients with AMI or OMI by intracoronary infusion into the infarct related artery,furthermore,the efficacy is beteer led in patients with AMI than in patients with OMI更多还原