用核素心脏显像评价冠心病患者骨髓干细胞移植术的效果

Comparison of ^(99)Tc^m-MIBI myocardial SPECT before and after bone marrow stem cells transplantation in patients with coronary artery disease

目的用核素心脏显像评价心脏骨髓干细胞移植术的效果。方法冠心病和扩张性心肌病患者36例,在骨髓干细胞移植术前及术后随访期进行运动+静息或静息+硝酸甘油介入心肌灌注断层显像,其中15例行心室显像检查。结果术后患者缺血心肌节段及梗死心肌节段减少,分别为术前(26±04)与(36±05)个及术后(15±04)与(20±04)个。左室射血分数平均增加183%,运动低下节段数明显减少。提示术后缺血心肌血运改善,心功能部分恢复,梗死心肌区有新生心肌细胞。结论用核素心脏显像评价骨髓干细胞移植术后近期效果较有价值。

Objective To evaluate the therapeutic efficacy of bone marrow stem cells transplantation in patients with coronary disease using myocardial perfusion imaging. Methods Stress-rest or rest-intravenous nitroglycerin infusion ~99 Tcm-methoxyisobutylisonitrile (MIBI) myocardial perfusion imaging were performed in a group of 36 patients with coronary artey disease before and after bone marrow stem cells transplantation. Left ventricular ejection fraction (LVEF) was studied with electrocardiogram (ECG) gated first pass in fifteen cases of them. Results The number of myocardial segments with reversible or irreversible perfusion defects in patients treated with stem cell transplantation were compared with that in untreated patients (1.5±0.4 vs 2.6±0.4, 2.0±0.4 vs 3.6±0.5, respectively). LVEF increased 18.3% after stem cells transplantation. The segmental wall motion of myocardium improved after implantation treatment. Conclusion Myocardial radionuclide perfusion imaging is useful in following up the results of bone marrow stem cells transplantation in patients with coronary artery disease.