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目的:通过建立小型猪心肌梗死模型,引起不同程度心功能变化,进行冠状动脉内自体骨髓细胞移植,探讨骨髓干细胞移植除与血管新生相关外,是否与动物基础心功能水平和侧枝循环变化相关。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变化,2周后经冠状动脉内移植骨髓单个核细胞或盐水。冠脉造影评估侧枝循环情况;左室造影检测左室射血分数(LVEF)变化;组织学检测新生血管数量。结果:移植后4周,注射PBS组动物LVEF呈进行性下降,各降低15．5％和14．2％(P<0．01);低EF +BMT组较移植前增加14．4％(P<0．01),而高EF+BMT组较移植前仅增加5．6％(P>0．05)。冠脉造影显示,骨髓干移植组侧枝循环数量较移植前增加,但无显著差异(P>0．05),注射PBS组也无显著变化(P>0．5)。碱性磷酸酶法显示,骨髓干移植组新生血管密度较注射PBS组增加(P<0．01),而低EF组移植骨髓干细胞引起的新生血管密度较高EF组增加63％(P<0．01)。相关分析显示,骨髓干细胞移植引起低EF组的心功能增加幅度与新生血管和基础心功能呈良好正相关(P<0．05),与侧枝循环级别增加无明显相关性(P>0．05)。结论:经冠状动脉内自体骨髓细胞移植更有利于低基础水平心脏功能恢复,其作用机制与血管新生和基础心功能水平密切相关。
OBJECTIVE: To establish a miniature swine model of myocardial infarction (AMI), and to induce changes of cardiac function in different degree. To investigate whether bone marrow stem cell transplantation is related to basic cardiac function and collateral circulation in animals except the angiogenesis. Methods: Ligation of left anterior descending blood vessels in different parts of miniature pig resulted in varying degrees of cardiac function changes. Two weeks later, bone marrow mononuclear cells or saline were transplanted via coronary artery. Coronary angiography assessment of collateral circulation; left ventricular angiography detection of left ventricular ejection fraction (LVEF) changes; histological examination of the number of neovascular. Results: After 4 weeks of transplantation, the LVEF in the PBS group decreased by 15.5% and 14.2% (P <0.01), while the increase in the EF + BMT group was 14.4% (P <0.01) P <0.01), while the high EF + BMT group only increased by 5.6% (P> 0.05) before transplantation. Coronary angiography showed that the number of collateral circulation in the bone marrow stem transplantation group increased compared with that before transplantation, but there was no significant difference (P> 0.05). There was no significant change in the PBS group (P> 0.5). Alkaline phosphatase assay showed that the density of neovascularization in bone marrow stem transplantation group was significantly higher than that in PBS group (P <0.01), while the level of neovascular density in high EF group was 63% higher than that in EF group .01). Correlation analysis showed that the increase of cardiac function induced by bone marrow stem cell transplantation in low EF group had a positive correlation with neovascularization and basic cardiac function (P <0.05), but not with the increase of collateral circulation (P> 0.05 ). CONCLUSION: Autologous transplantation of autologous bone marrow cells in coronary artery is more conducive to the restoration of cardiac function at a low basic level, and its mechanism of action is closely related to angiogenesis and basic cardiac function.