【摘要】 目的：研究经冠状动脉移植骨髓单个核细胞治疗心肌梗死的最佳时间窗。方法：结扎小型猪冠状动脉前降支90 min 再灌注制备心肌梗死模型,分为2小时移植组、2小时对照组、1周移植组和1周对照组,每组7只。移植组在结扎后2小时和1周经冠状动脉移植(8～10)×10~7个 PKH26标记的骨髓单个核细胞,对照组注射等体积培养基结扎后6周检测心功能变化并行了病理检查。结果：两个移植组在心肌梗死区均可找到移植细胞,其Ⅷ因子和 desmin 免疫组化染色均为阳性。血流动力学指标显示：结扎后6周较结扎后90分钟相比.2小时移植组的左心室压力最大下降速度和心排量显著升高(P＜0.05)；1周移植组的左心室舒张未压和心排量显著改善(P＜0.05)。超声心动图指标显示结扎后6周时2小时移植组的每搏排血量和心排量显著高于2小时对照组(P＜0.05)；1周移植绀结扎后6周-结扎前射血分数的差值明显高于1周对照组 (P＜0.05)。两移植组结扎后6周的各项指标均无显著差异(P 均＞0.05)。1周移植组梗死区的小血管数量明显高于2 小时移植组(P＜0.01)。结论：在结扎后2小时和1周时经冠状动脉移植的骨髓细胞均能定植于心肌梗死区,并可向心肌细胞和血管内皮细胞方向分化,有改善心功能的潜能。在结扎后1周移植能更有效地促进小血管新生。更多还原

【Abstract】 Objective:To investigate the best tinting for intracoronary transplanlation of bone marrow mononuclear cells（BM-MNCs） after myocardial infarction. Methods:A 90-minute left anterior descending coronary artery ligation was undertaken to produce acute myocardial infarction and followed by reperfusion in 28 swine which were divided into 4 groups:2 hour transplantation group（n=7）,2 hour control group（n=7）,1 week transplantation group（n=7）and 1 week control group（n=7）.（8-10）×10⁷ BM-MNCs labeled with PKH26 previously in transplantation group or culture medium of the same volume in control group were intracoronarily infused into infarction-related arteries 2 hour and 1 week after tigation.Six weeks after ligation,histological characteristics and heart function were studied. Results:An the specimens of two transplantation groups,labeled cells were found in the infarcted region,lmmunochemical staining showed that factor Ⅷ and desmin were positive.The histological findings were similar between the two transplant ation groups.The hemodynamie parameters showed that left ventricular-dp/dt_max and cardiac output（CO）of the 2 hour transplantation group at 6 weeks after ligation were increased（P＜0.05）in comparison with those at 90 minutes after ligation,so did left ven- tricular end-diastolic pressure and CO of 1 week transplantation group.The echocardiographic parameters showed in 2 hour trans- plantation group,stroke volume and CO at 6 weeks after ligation were increased（P＜0.05）in comparison with those in the control group.In 1 week transplantation group,before and 6 weeks after ligation ejection fraction was significontly increased（P＜0.05）in comparison with that in 1 week control group.Between two treatment groups,no significant difference was found on hemodynamic parameters and echocardiographic parameters.The number of vessels of 1 week transplantation group was larger than that of 2 hour transplantation group（P＜0.01）. Conclusion:Autologous BM-MNCs after being intracoronarily transplanted into ischemic region at 2 hours or 1 week after ligation could engraft,grow and differentiate into cardiomyogenic cells and endothelial cells,and have clinical potential in impro- ving heart function.Transplantation at 1 week after ligation can promote angiogenesis more effectively.更多还原