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目的探讨骨髓干细胞移植(BMT)对哪种程度的心力衰竭更有效。方法结扎小型猪不同部位左前降支血管,造成不同程度心功能(左心室射血分数,LVEF)变化,2周后,将30只造模型成功动物随机分为3组,高LVEF(HLVEF,LVEF≥50%)组,中LVEF(MLVEF,50%>LVEF≥40%)组,低LVEF(LLVEF,LVEF<40%)组,每组分为两个亚组,各组随机经冠状动脉内移植骨髓单个核细胞或磷酸盐缓冲液(PBS),每组各5只动物。结果移植后4周,注射PBS动物LVEF呈进行性下降;而MLVEF+BMT组较移植前增加11.9%(P<0.05),明显高于HLVEF+BMT组和LLVEF+BMT组。冠状动脉造影显示,只有MLVEF+BMT组侧支循环数量较移植前有显著性增加。免疫组织化学显示,注射BMT的3组血管密度明显高于注射PBS的3组,以MLVEF+BMT组最明显。结论经冠状动脉内自体BMT更有利于中度心力衰竭受体心脏功能恢复和血流灌注改善。
Objective To investigate the degree of heart failure that bone marrow stem cell transplantation (BMT) is more effective. Methods Left anterior descending coronary arteries were ligated in different parts of miniature pigs, causing varying degrees of cardiac function (left ventricular ejection fraction, LVEF). Two weeks later, 30 model animals were randomly divided into 3 groups: high LVEF (HLVEF, LVEF) ≥50%), LVEF (50%> LVEF≥40%), low LVEF (LLVEF, LVEF <40%) were divided into two subgroups. Each group was randomly divided into two groups: Bone marrow mononuclear cells or phosphate buffered saline (PBS), 5 animals in each group. Results Four weeks after transplantation, the LVEF in PBS-injected mice decreased progressively. In MLVEF + BMT group, the increase was 11.9% (P <0.05), significantly higher than that in HLVEF + BMT group and LLVEF + BMT group. Coronary angiography showed that only the number of collateral circulation in MLVEF + BMT group was significantly increased compared with that before transplantation. Immunohistochemistry showed that the three groups injected BMT vascular density was significantly higher than the three groups injected with PBS, MLVEF + BMT group most obvious. CONCLUSIONS: Coronary autologous BMT is more favorable for heart function recovery and perfusion improvement in patients with moderate heart failure.