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目的观察自体骨髓单个核细胞移植治疗AMI的安全性及远期效果。方法选择2003年8月~2006年3月在我院心内科住院的男性前壁AMI患者10例。于AMI后2周内将自体骨髓单个核细胞悬液([7.38±3.21)×109/L]10ml经冠状动脉注入梗死区域。于移植前和术后1年,行超声心动图检查和组织多普勒小剂量多巴酚丁胺负荷试验。评价心功能和坏死局部心肌最大位移。纪录不良事件。结果10例病人均完成随访。1.左室舒张末期内径(LVIDD)、收缩末期内径(LVESD)、LVEF、舒张早期与舒张晚期峰值运动速度比(E/A),每搏输出量、左室短轴缩短率无统计学差异(P>0.05)。2.静息和负荷状态梗死局部(基底部、中间段、心尖部)心肌最大位移增加(P<0.05)。2例患者出现频发室早。结论未发现骨髓单个核细胞移治疗AMI有严重不良反应。此治疗可稳定心功能、防止心脏扩大,增加梗死局部心肌运动的最大位移。
Objective To observe the safety and long-term effect of autologous bone marrow mononuclear cell transplantation in the treatment of AMI. Methods From August 2003 to March 2006, 10 patients with AMI in the male anterior wall hospitalized in our department of cardiology were enrolled. Within 2 weeks after AMI, 10ml of autologous bone marrow mononuclear cell suspension ([7.38 ± 3.21] × 109 / L] was infused into infarct area via coronary artery. Before transplantation and one year after surgery, echocardiography and tissue Doppler low-dose dobutamine stress were performed. Evaluation of cardiac function and necrosis of the maximum myocardial displacement. Record adverse events. Results All the 10 patients were followed up. Left ventricular end-diastolic diameter (LVIDD), end-systolic diameter (LVESD), LVEF, peak diastolic velocity (E / A), stroke volume per stroke and shortening of left ventricular short axis were not significantly different (P> 0.05). Resting and loading state infarction (basal part, middle segment, apex) myocardial maximum displacement increased (P <0.05). Two patients had frequent premature ventricular occlusion. Conclusion There was no serious adverse reaction of bone marrow mononuclear cells in the treatment of AMI. This treatment can stabilize heart function, prevent heart enlargement, increase the maximum displacement of myocardial infarction.