骨髓单个核细胞治疗急性心肌梗死患者的临床观察

Clinical application of autologous intracoronary mononuclear bone marrow cell transplantation in the treatment of infracted myocardium

目的 :探讨自体骨髓单个核细胞通过冠脉内注射对于急性心肌梗死患者心功能的改善作用及其机制 ,并评估其安全性。方法 :选择 15例急性心肌梗死患者 ,利用Ficoll 淋巴细胞分离液分离出骨髓单个核细胞 ,在对患者进行标准药物和介入治疗的基础上 ,将骨髓单个核细胞经导管注射到心肌梗死的相关动脉内。同时选择 17例接受标准药物和介入治疗的急性心肌梗死患者做对照。结果 :在 4个月的随访中 ,通过对患者进行超声心动图和心肌核素显像检查比较得出 :细胞移植组的心肌梗死面积显著减少。两组的射血分数和左室收缩末期和舒张末期容积均有提高 ,而细胞移植组提高更为显著。结论 :经冠脉自体骨髓单个核细胞移植在临床应用上是安全有效的 ,其机制可能是骨髓细胞介导的心肌再生和血管再生。

Objective To investigate whether the intracoronary transplantation of autologous mononuclear bone marrow cells (BMCs) can improve cardiac performance in patients with acute myocardial infarction, and to evaluate the safety. Methods Fifteen patients with acute myocardial infarction were selected and their mononuclear bone marrow cells were separated with Ficoll-Paque reagent. After standard therapy, they were transplanted with BMCs through over-the-wire-balloon placed into the infarcted artery. Another 17 patients with acute myocardial infarction were treated with standard therapy alone. Results After 4 months of follow-up, the infarcted region had decreased significantly within the cell therapy group. Whatsmore, cardiac examinations indicated significant improvement in ejection fraction and left ventricular end-systolic and end-diastolic volume in both groups, the improvements in cell therapy group are more significant. Conclusion Autologous intracoronary mononuclear bone marrow cell transplantation seems safe and effective under clinical conditions. Its therapeutic effect may be attributed to BMC-associated myocardial regeneration and neovascularization.