[精品]自体骨髓干细胞移植治疗心肌梗死患者心肌代谢及收缩功能的变化.doc

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1、【关键词】干细胞;，骨髓;,干细胞移植;，心肌梗死［摘要］目的：探讨白体骨髓间充质干细胞(BMSCs)和单个核细胞(BMMNCs)经梗死相关冠状动脉(IRA)移植对冠心病心肌梗死患者近、屮期心功能、心肌代谢的影响及其安全性。方法：对14例冠心病伴心肌梗死史1〜35个月的患者。细胞移植组8例，通过冠脉系统将BMSCs和BMMNCs植入心肌梗死区，余6例常规治疗。两组患者均于术前和术后3,8个月行SPECT双核素心肌显像、二维超声心动图、6min步行试验及动态心电图检杏。结果：移植组患者在梗死相关冠脉开通示注入干细胞，8例心功能从II〜IV级

2、提高至I〜I【级，6min步行试验从(320.72±60.47)m提高至(406.88±68.31)m,6个月后乂提高至(484.79±81.00)m06例前壁心梗患者3,8月后LVEF由术前的42.5%提高至49.5%和54%;术麻3,8月心肌双核索检查缺损区占整个心肌体积由术前的45.5%减少至39%和25%o6例对照组患者术后3月EF较术前提高，心肌双核索检查缺损区占心肌体积减少，术肩8刀与术拆3月无明显改变。2例下壁心肌梗死患者经于细胞移植临床效果不明显。结论：「I体BMSCs和BMMNCs经冠脉移植治疗冠心病心肌梗死，可以显著改

3、善前壁心肌梗死患者左室收缩功能和心肌代谢。［关键词］干细胞；骨髓；干细胞移植；心肌槌死Impactofautologousmononuclearbonemarrowcellstransplantationonearlyandmed・termoutcomesonthecardiacfunctionandmyocardialmetabolicinpatientswithmyocardialinfactionZHANGYu・yamDINGZhi・jian,ZHANGFu-min,YANGZhi-jian,WANGYin,CHENJie-zhon

4、g,SUNYong,XULong-bao1,XUYu-hong(1.DepartmentofCardiology,No.2People'sHospitalofChangzhou,NanjingMedicalUniverty,ChangzhouJiangsu213003;2.DepartmentofCardiology,No.1AffiliatedHospitalofNanjingMedicalUniverty,NanjingJiangsu210029,China)［Abstract］Objective:Toevaluatetheearly

5、andmed-termoutcomesoftrans-plantationofautologousbonemarrowmesenchymalstemcell(BMSCs)andmonoucleuscells(BMMNCs)fortreatingcoronanyheartdisease.Methods:Fourteenpatientswhohadsufferedfromcoronaryheartdiseasewithmyocardialinfarc-tion,wereenrolledinthisprospective,nonrandomiz

6、ed,controlstudy(8patientsincelltransplantationgroup;6incontrolgroup)4utologousBMSCs+BMMNCsweret「ansplantedintothemyocardialinfractedareainthecelltransplantationgroupthroughintracoronaryway.AIIpatientsunderwent3-monthand8-monthfollow-up,6minu怕stest,2DDopplerechocardiogram,

7、SPECT.Results:After3monthsand8monthsfollow-up,cardiacfunctionwereimproved:6minutsdistancewasproIongedfrom320.72±60.47mto406.88±68.31and484.79±81.00m.leftventricularejectionfraction(LVEF)wasincreasedby49.5%and54%vs42.5%,theinfarctdefectedregionswasredusedby39%and25%vs45.5%

8、beforetransplantationin6patientswithanteriormyocardialinfarction」ncontrolgroup,2DDopplerechocard