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目的:观察骨髓单个核细胞(mononuclear bone marrow cell,MBMC)移植对缺血性心肌病患者左心功能及血浆利钠肽的影响。方法:36例缺血性心肌病患者分为细胞移植组24例和常规治疗组12例。结果:治疗3d后移植组及对照组心房利钠肽(atrial natriuretic peptide,ANP)、脑利钠肽(brain natriuretic peptide,BNP)均无明显变化,治疗7d后,移植组BNP下降了67.76%,对照组下降了24.1%;移植组ANP上升36.65%,而对照组下降14%,超声心动图结果显示:移植组左心室射血分数(LVEF)由(34.8±1.27)%升至(44.45±2.08)%(P<0.001),对照组LVEF由(36.20±3.80)%升至(38.97±2.76)%(P<0.05)。结论:MBMC经冠状动脉移植后早期(1周内)可明显改善心力衰竭患者的心功能,其机制之一可能为外源ANP生成而发挥的利钠、利尿、扩血管作用。
Objective: To observe the effect of bone marrow mononuclear bone marrow cell (MBMC) transplantation on left ventricular function and plasma natriuretic peptide in patients with ischemic cardiomyopathy. Methods: Thirty-six patients with ischemic cardiomyopathy were divided into cell transplantation group (n = 24) and routine treatment group (n = 12). Results: After 3 days of treatment, the atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) of the transplantation group and the control group showed no significant changes. After 7 days of treatment, the BNP level in the transplantation group decreased by 67.76% The control group decreased by 24.1%. The ANP increased by 36.65% in the transplantation group compared with 14% in the control group. The echocardiographic results showed that the left ventricular ejection fraction (LVEF) increased from (34.8 ± 1.27)% to (44.45 ± 2.08) ) (P <0.001). The LVEF increased from (36.20 ± 3.80)% to (38.97 ± 2.76)% in the control group (P <0.05). Conclusion: MBMC can improve cardiac function in patients with heart failure in early (1 week) after coronary artery transplantation. One of the mechanisms may be the effect of natriuretic, diuretic and vasodilation of exogenous ANP.