【摘要】 目的:探讨自体骨髓间充质干细胞(BMSCs)和单个核细胞(BMMNCs)经梗死相关冠状动脉(IRA)移植对冠心病心肌梗死患者近、中期心功能、心肌代谢的影响及其安全性。方法:对14例冠心病伴心肌梗死史1~35个月的患者。细胞移植组8例,通过冠脉系统将BMSCs和BMMNCs植入心肌梗死区,余6例常规治疗。两组患者均于术前和术后3,8个月行SPECT双核素心肌显像、二维超声心动图、6 m in步行试验及动态心电图检查。结果:移植组患者在梗死相关冠脉开通后注入干细胞,8例心功能从Ⅱ~Ⅳ级提高至Ⅰ~Ⅱ级,6 m in步行试验从(320.72±60.47)m提高至(406.88±68.31)m,6个月后又提高至(484.79±81.00)m。6例前壁心梗患者3,8月后LVEF由术前的42.5%提高至49.5%和54%;术后3,8月心肌双核素检查缺损区占整个心肌体积由术前的45.5%减少至39%和25%。6例对照组患者术后3月EF较术前提高,心肌双核素检查缺损区占心肌体积减少,术后8月与术后3月无明显改变。2例下壁心肌梗死患者经干细胞移植临床效果不明显。结论:自体BMSCs和BMMNCs经冠脉移植治疗冠心病心肌梗死,可以显著改善前壁心肌梗死患者左室收缩功能和心肌代谢。更多还原

【Abstract】 Objective: To evaluate the early and med-term outcomes of trans-plantation of autologous bone marrow mesenchymal stem cell(BMSCs) and monoucleus cells(BMMNCs) for treating coronany heart disease.Methods: Fourteen patients who had suffered from coronary heart disease with myocardial infarction,were enrolled in this prospective,nonrandomized,control study(8 patients in cell transplantation group;6 in control group).Autologous BMSCs+BMMNCs were transplanted into the myocardial infracted area in the cell transplantation group through intracoronary way.All patients underwent 3-month and 8-month follow-up,6 minutes test,2D Doppler echocardiogram,SPECT. Results: After 3 months and 8 months follow-up,cardiac function were improved :6 minuts distance was prolonged from 320.72±60.47 m to 406.88±68.31 and 484.79±81.00 m.left ventricular ejection fraction(LVEF) was increased by 49.5% and 54% vs 42.5%,the infarct defected regions was redused by 39% and 25% vs 45.5% before transplantation in 6 patients with anterior myocardial infarction.In control group,2D Doppler echocardiogram,SPECT were improved in 3 mounths but not improved further in 8 mounths after PCI.In cell trans plantation group 2 patients with inferior myocardial infarction was not changed significactly. Conclusion: The preliminary study showed that in the patients who suffered from coronary heart disease compliated with anterior myocardial infarction,transplantation of BMSCs+BMMNCs could improve cardiac fuction and cardiac metabolism.更多还原