目的:探讨对照研究自体骨髓单个核细胞(BM-MNC s)冠脉内移植治疗急性与陈旧性心肌梗死的临床疗效。方法:选择35例NYHA心功能分级Ⅱ~Ⅲ级行择期介入治疗术的心肌梗死患者,急性心梗患者20例,陈旧性心梗患者15例。两组患者在介入治疗术结束后均通过大腔导管于梗死相关血管注入BM-MNC s。用流式细胞仪对BM-MNC s进行细胞计数及成分鉴定;术前、术后45d、90d行静息T e99m SPECT检查进行疗效判断。结果:①用F ico ll密度梯度离心法获得单个核细胞1.7×108~5.7×108(3.6±1.7×108)个,细胞活性均大于92%;CD 34+细胞2.56%±0.98%,AC 133+细胞0.56%±0.23%。②急性心梗组术前、术后45d、90d静息T e99m SPECT心肌灌注缺损区面积占总面积百分比分别为25.11%±7.26%、17.89%±5.49%、15.19%±3.95%(P<0.05);陈旧性心梗组术前、术后45d、术后90d静息T e99m SPECT心肌灌注缺损区面积占总面积百分比分别为25.28%±7.38%、21.12%±6.82%、18.86%±6.41%(P<0.05)。急性心梗组与陈旧性心梗组术后45dSPECT灌注缺损区面积较术前分别缩小28.75%和16.46%(P<0.05);急性心梗组与陈旧性心梗组术后90d SPECT灌注缺损区面积较术后45d分别缩小15.09%和10.70%(P<0.05)。结论:自体骨髓单个核细胞梗死相关冠脉内移植治疗急性心肌梗死与陈旧性心梗均有一定的疗效,但对急性心梗的疗效优于陈旧性心梗。 Objective: To investigate the clinical efficacy of intracoronary transplantation of autologous bone marrow mononuclear cells (BM-MNCs) in the treatment of acute and old myocardial infarction. Methods: Thirty-five patients with myocardial infarction who underwent selective elective interventional therapy NYHA functional class Ⅱ ~ Ⅲ were selected. Twenty patients with acute myocardial infarction and 15 patients with old myocardial infarction were included. Both groups received BM-MNC s in the infarct-related vessels via the large-lumen catheter after interventional therapy. The cytometry and composition identification of BM-MNC s were performed by flow cytometry. The preoperative and postoperative 45 days, 90 days postoperative T e99m SPECT examination was used to judge the curative effect. Results: ① The single cell count of 1.7 × 108 ~ 5.7 × 108 (3.6 ± 1.7 × 108) was obtained by Ficoll density gradient centrifugation. The cell viability was over 92%. The CD 34+ cells were 2.56% ± 0.98% + Cells 0.56% ± 0.23%. (2) The percentage of myocardial ischemic area of ​​T e99m SPECT at preoperative and postoperation 45d, 90d after operation was 25.11% ± 7.26%, 17.89% ± 5.49%, 15.19% ± 3.95% respectively (P <0.05 ). The area of ​​myocardial perfusion defects in premature myocardial infarction group at 45 days and 90 days after operation were 25.28% ± 7.38%, 21.12% ± 6.82% and 18.86% ± 6.41% (P <0.05). The area of ​​SPECT perfusion in the acute myocardial infarction group and the old myocardial infarction group decreased by 28.75% and 16.46%, respectively (P <0.05) 45 days after operation; the SPECT perfusion defect area in the acute myocardial infarction group and the old myocardial infarction group The area was reduced by 15.09% and 10.70% respectively compared with 45 days after operation (P <0.05). CONCLUSION: Autologous bone marrow mononuclear cell infarction-related intracoronary transplantation for acute myocardial infarction and old myocardial infarction have a certain effect, but the effect of acute myocardial infarction is superior to the old myocardial infarction.