急性心肌梗死患者自体骨髓干细胞移植治疗效果随访

中国临床药理学与治疗学 ›› 2013, Vol. 18 ›› Issue (6): 674-679.

急性心肌梗死患者自体骨髓干细胞移植治疗效果随访

朱琳琳¹, 谢向荣², 张娟¹, 单守杰¹, 陈绍良¹

¹南京医科大学附属南京第一医院心内科,南京210006,江苏,
²皖南医学院弋矶山医院心内科,芜湖241000,安徽

收稿日期:2012-11-20 修回日期:2013-05-15 发布日期:2013-06-19
作者简介:朱琳琳,女,硕士,主治医师,研究方向:心血管疾病的临床诊疗。Tel: 025-52271340 E-mail: yinyinye9157793@126.com

Long-term efficacy of intracoronary stem cells transplantation in patients with acute myocardial infarction

ZHU Lin-lin¹, XIE Xiang-rong², ZHANG Juan¹, SHAN Shou-jie¹ , CHEN Shao-liang¹

¹Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, Jiangsu,China,
²Department of Cardiology, Yijishan Hospital,Wannan Medical College,Wuhu 241001,Anhui,China

Received:2012-11-20 Revised:2013-05-15 Published:2013-06-19

摘要/Abstract

摘要： 目的: 研究急性心肌梗死(Acute myocardial infarction,AMI)患者自体骨髓间质干细胞(Mesenchymal stem cells,MSCs)冠脉内注射治疗的安全性以及对心功能的改善作用,并探讨其可能机制。方法: 20例急性心肌梗死患者(治疗组)经皮冠状动脉介入(PCI)术后抽取骨髓分离、培养、扩增后12~14 d 行冠脉内注射,另选取20例PCI术后拒绝行细胞治疗的急性心肌梗死患者作为对照组,PCI术后1周及1年进行临床随访、超声心动图及¹⁸氟-脱氧葡萄糖单光子心肌断层显像(¹⁸F-FDG-SPECT)。结果: 治疗组未见与移植有关的体温升高及恶性心律失常发生。与对照组比较,1年后治疗组超声心动图心脏收缩、舒张功能指标及SPECT代谢缺损指标有明显改善,差异具有统计学意义(P<0.05)。结论: 急性心肌梗死患者自体骨髓间质干细胞冠脉内注射安全有效,可以改善患者心功能及远期预后;骨髓来源的心肌细胞生成及血管新生可能为其机制。

关键词: 心肌梗塞, 治疗, 骨髓移植, 自体, 再生

Abstract: AIM: To investigate the security as well as the improvement of cardiac function in patients with acute myocardial infarction who ac-cepted intracoronary transplantation of autologous bone marrow mesenchymal stem cells (MSCs),and to discuss the possible mechanism. METHODS: 20 cases of acute myocardial infarction patients after percutaneous coronary intervention (PCI) received intracoronary transplantation of MSCs. (treatment group). Another 20 patients who refused stem-cell therapy after PCI served as control (conrol group). All patients underwent clinical evaluation, 2D/TDI echocardiogram, and ¹⁸F-FDG-SPECT at 1 week/1 year after PCI.RESULTS: Body temperature elevation or malignant arrhythmia associated with transplantation was not found in treatment group. Compared with the control group, echocardiographic systolic and diastolic function parameters and SPECT metabolic defects indicators were improved significantly in treatment group 1 year after PCI,there were statistical differences(P<0.05).CONCLUSION: Intracoronary transplantation of MSCs is safe and effective, and may significantly improve long-term cardiac performance. MSCs-associated myocardial regeneration and neovascularization may be the possible mechanisms.

Key words: Myocardial infarction, Therapy, Bone marrow transplantation, Autologous, Anagenesis

中图分类号:

R541

朱琳琳, 谢向荣, 张娟, 单守杰, 陈绍良. 急性心肌梗死患者自体骨髓干细胞移植治疗效果随访[J]. 中国临床药理学与治疗学, 2013, 18(6): 674-679.

ZHU Lin-lin, XIE Xiang-rong, ZHANG Juan, SHAN Shou-jie , CHEN Shao-liang. Long-term efficacy of intracoronary stem cells transplantation in patients with acute myocardial infarction[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2013, 18(6): 674-679.

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