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目的 :为研究自体骨髓单个核细胞经冠脉内移植治疗缺血性心力衰竭的可行性和疗效。方法 :成人缺血性心力衰竭病人 2 7例 ,抽取骨髓后密度梯度离心法分离出骨髓单个核细胞 ,经外周动脉穿刺插管 ,直接将自体骨髓单个核细胞注入冠脉。结果 :术后随访显示病人的活动能力明显改善 ,NYHA提高 >2级 12例 ,>1级 4例 ,EF明显提高 (36 .4± 12 .5 % ,vs 4 6 .3±10 .6 % ,P <0 .0 0 1) ,99Tc心脏ECT检查心肌缺血区可见岛状放射性同位素充盈 ,提示有部分新生心肌存在。因心肌再梗死住院 1例 ,其他 15例均无明显症状并院外存活。结论 :自体骨髓细胞移植心肌细胞成形术 ,对缺血心肌的恢复和改善病人临床心功能有肯定疗效 ,该方法在临床上安全、简单、可行 ,对病人没有明显的负影响。
OBJECTIVE: To investigate the feasibility and efficacy of autologous bone marrow mononuclear cells for coronary artery transplantation for ischemic heart failure. Methods: Twenty-seven adult patients with ischemic heart failure were divided into eight groups according to the density gradient centrifugation method. The bone marrow mononuclear cells were isolated and perfused through the peripheral artery to directly inject the autologous bone marrow mononuclear cells into coronary arteries. Results: The postoperative follow-up showed that the activity of patients was significantly improved. The NYHA increased> 2 grade in 12 cases and> 1 grade in 4 cases. EF was significantly improved (36.4 ± 12.5% vs 46.3 ± 10.6% , P <0.01). The 99Tc cardiac ECT showed myocardial ischaemia in the visible island radioactive isotope filling, suggesting that some newborn myocardium exists. One case of myocardial infarction hospitalization, the other 15 cases were no obvious symptoms and survival outside the hospital. CONCLUSION: Autologous bone marrow cell transplantation for cardiomyoplasty has positive curative effect on the recovery of ischemic myocardium and improvement of clinical cardiac function. The method is safe, simple and feasible in clinic and has no obvious negative impact on patients.