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背景:人脐血单个核细胞作为一类移植细胞日益引起关注,但多为基础研究。目的:就脐血单个核细胞移植治疗老年急性广泛前壁心肌梗死后心源性休克合并重度心力衰竭1例进行报道。方法:急性广泛前壁心肌梗死后心源性休克合并重度心力衰竭女性患者1例,经冠心病介入治疗置入3枚支架及内科药物系统治疗,仍有反复发作性呼吸困难等心力衰竭症状。使用冠脉微导管经左冠前降支将含有脐血单个核细胞2.4×108个,总计50mL干细胞悬液注射到梗死相关血管。结果与结论:干细胞移植后随访近4个月,患者无不良反应发生,心力衰竭症状明显好转。射血分数从术前22%,移植后42%,到移植后21d升高至53%。血脑钠肽从术前1730ng/L,移植后854ng/L,到移植后21d降低至264ng/L。移植后4个月患者无胸闷、气短、乏力、呼吸困难发生,可以从事日常活动。说明脐血单个核细胞移植治疗急性心肌梗死后心源性休克合并心力衰竭安全、有效。
BACKGROUND: Human umbilical cord blood mononuclear cells are attracting more and more attention as a kind of transplanted cells, but many are basic research. OBJECTIVE: To report 1 case of cardiogenic shock complicated with severe heart failure after transplantation of cord blood mononuclear cells in elderly patients with acute extensive anterior myocardial infarction. Methods: One case of female patients with cardiogenic shock complicated with severe heart failure after acute extensive anterior myocardial infarction was treated with three stents and medical medicine system after interventional therapy of coronary heart disease. Symptoms of heart failure such as recurrent dyspnea still exist. Using coronary microcatheter, left anterior descending coronary artery, 2.4 × 108 mononuclear cells containing umbilical cord blood were collected. A total of 50 mL stem cell suspension was injected into the infarct-related blood vessels. RESULTS AND CONCLUSION: After 4 months of follow-up of stem cell transplantation, no adverse reactions occurred in patients and symptoms of heart failure improved significantly. The ejection fraction increased from 22% preoperatively, 42% posttransplantation to 53% post 21 day posttransplantation. Blood brain natriuretic peptide from preoperative 1730ng / L, 854ng / L after transplantation, 21d after transplantation reduced to 264ng / L. 4 months after transplantation patients without chest tightness, shortness of breath, fatigue, dyspnea, can engage in daily activities. Explanations of cord blood mononuclear cell transplantation in patients with acute myocardial infarction after cardiac shock and heart failure safe and effective.