冠状动脉内自体骨髓单个核细胞移植治疗心肌梗死的临床研究

Repair of infarcted myocardium by autologous intracoronary mononuclear bone marrow cells transplantation in humans

目的 探讨冠状动脉内自体骨髓单个核细胞移植治疗急性心肌梗死的安全性和疗效。方法 19例拟行介入治疗的急性心肌梗死患者, 11例通过放置于梗死相关动脉内的球囊导管,进行自体骨髓单个核细胞移植。另外8例对照组患者以生理盐水代替细胞进行移植。结果 3个月随访时,在细胞治疗组梗死的范围显著缩小(32. 4%±4. 8%到16. 9%±2. 9%,P<0. 001),与对照组相比也明显较小(16. 9%±2. 9% 比28. 1%±2. 8%,P<0. 001)。只有在细胞治疗组,梗死的心室壁运动速度明显增加(2. 05cm/s±1. 08cm/s到4. 47cm/s±0. 59cm/s,P<0. 001)。细胞治疗组左心室(左室)射血分数,收缩期室壁增厚率以及梗死区心肌灌注显著提高。结论 自体骨髓单个核细胞冠状动脉内移植安全有效。其疗效可能与骨髓细胞引起的心肌再生和血管新生有关。

Objective To evaluate whether autologous intracoronary mononuclear bone marrow cells transplantation may cure acute myocardial infarction(AMI).Methods 19 patients who had suffered AMI were about to receive interventional therapy.Among them,11 patients were transplanted with autologous mononuclear bone marrow cells (BMCs) via a balloon catheter placed into the infarct-related artery.The other 8 patients, who were injected with physiological saline instead of BMCs,served as controls.Results After 3 months of follow-up,the infarct region had decreased significantly within the cell therapy group(from 32.4%±4.8% to 16.9%±2.9%,P<0.001) and was also significantly smaller(16.9%±2.9% vs 28.1%±2.8%,P<0.001).Infarct wall movement velocity increased significantly only in the cell therapy group (from 2.05 cm/s±1.08 cm/s to 4.47 cm/s±0.59 cm/s,P<0.001).There was also significant improvement in left ventricular ejection fraction and systolic wall thickening rate and myocardial perfusion of the infarct region within the cell therapy group.Conclusions Intracoronary transplantation of autologous mononuclear BMCs is safe and effective.The therapeutic effect may be attributed to BMC-associated myocardial regeneration and neovascularization.