论文部分内容阅读
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6例冠心病伴心肌梗死患者,男5例、女1例,平均年龄62岁(51~75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(0.9~3.2)×106个,骨髓单个核细胞数为(1.6~5.3)×106个。术前和术后6个月分别行99mTc-MIBI心肌灌注显像、二维超声心动图、心电图和动态心电图检查。结果6例患者二维超声心动图检查示左室射血分数(LVEF)较术前明显增加[(52.33±8.70)%vs(42.92±12.60)%,P<0.05],左室舒张期内径(LVDd)较术前明显减少[(54.33±4.84)vs(61.67±6.83),P<0.05];6例99mTc-MIBI检查显示梗死部位心肌灌注明显改善。术中及术后随访6~18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。
Objective To study the effect and safety of autologous bone marrow stem cells transplanted by coronary artery on cardiac function in patients with myocardial infarction. Methods Six patients with coronary heart disease and myocardial infarction, 5 males and 1 females, with an average age of 62 years (51-75 years). The autologous bone marrow stem cells were isolated and cultured in vitro for 2 to 3 weeks. Infarct-related “criminals” vessels were opened, Transplantation of bone marrow mesenchymal stem cells transplanted into the myocardial infarction area of the patients. The number of transplanted bone marrow mesenchymal stem cells was (0.9 ~ 3.2) × 106, the number of bone marrow mononuclear cells was (1.6 ~ 5.3) × 106. 99mTc-MIBI myocardial perfusion imaging, two-dimensional echocardiography, electrocardiogram and ambulatory electrocardiography were performed before and 6 months after operation. Results The two-dimensional echocardiography showed that left ventricular ejection fraction (LVEF) was significantly increased in 6 patients (52.33 ± 8.70)% vs (42.92 ± 12.60)%, P <0.05; left ventricular diastolic diameter (54.33 ± 4.84 vs 61.67 ± 6.83, P <0.05]. Six cases of 99mTc-MIBI showed that myocardial perfusion was significantly improved in the infarction area. Intraoperative and postoperative follow-up of 6 to 18 months without arrhythmia and other complications occurred. Conclusions Autologous bone marrow stem cells can be used to treat coronary heart disease by coronary artery transplantation. Myocardial infarction can inhibit left ventricular remodeling and improve cardiac function.