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目的:观察急性心肌梗死延迟PCI术后自体骨髓单个核细胞移植对心肌灌注及左室功能的影响。方法:20例急性心肌梗死患者在病情稳定后7～10天,行延迟PCI术。随机分成骨髓细胞移植组(10例)和对照组(10例),观察术前、术后1个月、术后6个月左心室舒张末内径(LVDd),左室射血分数(LVEF)。以及术前、术后1个月的经静脉心肌超声造影(IMCE)。结果:移植组LVEF由术前(37.26±4.21),1月后上升到(54.42±5.26)(P<0.05);而对照组差异不显著[(38.86±4.63)vs(40.28±4.56)](P>0.05)。LVDd移植组术后6个月与术前比较差异不显著[(50.23±3.42)vs(52.48±3.26)](P>0.05);而对照组[(50.96±2.68)vs(64.31±3.28)](P<0.05),心脏有扩大趋势。经静脉心肌超声造影(IMCE),A·β(dB/s)移植组由术前的(2.37±0.16)增加到术后的(15.60±0.24);较对照组(2.06±0.12至7.98±0.23)增加更为明显(P<0.05)。结论:急性心肌梗死延迟PCI术后自体骨髓单个核细胞移植可改善患者左室收缩功能,延缓左室扩大;可改善梗死区心肌灌注,明显增加心肌血流量。
Objective: To observe the effects of autologous bone marrow mononuclear cells transplantation on myocardial perfusion and left ventricular function in patients with acute myocardial infarction after delayed PCI. Methods: Twenty patients with acute myocardial infarction were treated with delayed PCI 7 to 10 days after the disease was stable. Randomly divided into bone marrow cell transplantation group (10 cases) and control group (10 cases), the left ventricular end-diastolic diameter (LVDd), left ventricular ejection fraction (LVEF) . And preoperative and postoperative 1 month intravenous myocardial contrast echocardiography (IMCE). Results: The LVEF in the transplantation group increased from (37.26 ± 4.21) months to (54.42 ± 5.26) months before surgery (P <0.05), while the difference was not significant in the control group (38.86 ± 4.63 vs 40.28 ± 4.56) P> 0.05). There was no significant difference between the LVDd group and the preoperative one at 6 months after operation ([(50.23 ± 3.42) vs (52.48 ± 3.26)] (P> 0.05), while in the control group (50.96 ± 2.68 vs 64.31 ± 3.28) (P <0.05), the heart has an expanding trend. Compared with the control group (2.06 ± 0.12 to 7.98 ± 0.23), IMCE and A · β (dB / s) in the transplantation group increased from 2.37 ± 0.16 to 15.60 ± 0.24 ) Increased more significantly (P <0.05). CONCLUSION: Acute myocardial infarction delayed autologous bone marrow mononuclear cell transplantation after PCI can improve left ventricular systolic function and prolong left ventricular expansion. It can improve myocardial perfusion and increase myocardial blood flow obviously.