自体骨髓基质干细胞移植对扩张型心肌病心功能及血浆脑钠肽的影响

Effects of autologous marrow mesenchymal stem cells transplantation on cardiac function and plasma brain natriuretic peptide in rabbits with dilated cardiomyopathy

目的探索自体骨髓基质干细胞(MSCs)移植对兔扩张型心肌病(DCM)心功能及血浆脑钠肽(BNP)的影响。方法36只健康大白兔经耳缘静脉注射盐酸阿霉素建立DCM模型后,将存活兔随机分为细胞移植组、对照组和假手术组。移植前和移植后4周,采用超声心动图测定左室收缩末期内径(LVDs)、左室舒张末期内径(LVDd)及左室射血分数(LVEF),并测定血浆BNP水平。移植后4周测定血流动力学指标,免疫荧光检测移植区组织内存活的移植细胞。结果移植后4周移植组的左心室收缩压、压力变化最大速率及LVEF明显高于其他两组(P<0.01)。移植组的LVDd、LVDs和左室舒张末压较假手术组明显减小(P<0.05、P<0.01)。移植后4周移植组的血浆BNP水平显著下降(P<0.01),而对照组及假手术组中均无显著性改变;移植组组织切片可见BrdU染色阳性细胞,核发绿色荧光,其他组均未见BrdU染色阳性细胞。结论MSCs移植能改善阿霉素诱导DCM的心功能,作用机制中神经体液调节可能起重要作用。

Objective To explore the effects of autologous marrow mesenchymal stem cells (MSCs) transplantation on cardiac function and plasma brain natriuretic peptide (BNP) in rabbits with adriamycin-induced dilated cardiomyopathy(DCM).Methods Thirty-aix healthy rabbits received adriamycin through ear-border vein to produce DCM model.The survivors were randomly divided into transplantion group, control group and sham group. Systolic left ventricular diameter (LVDs), diastolic left ventricular diameter (LVDd) and left ventricular ejection fraction (LVEF) were measured by echocardiography, and plasma BNP levels were determined before and 4 weeks after surgery, lndexes of hemodynamics were assessed 4 weeks after surgery. Viable transplant cells were detected by immunofiuorescence.Results Left ventricular systolic pressure (LVSP), dp/dt(max) and LVEF in the transplantion group were the highest in the three groups (P<0.01). LVDd, LVDs and left ventricular end-diastolic pressure(LVEDP) in the transplantion group were smaller than in the sham group (P<0.05, P<0.05,P<0.01, respectively ). Plasma BNP levels in the transplantion group decreased significantly at 4 weeks after transplantion(P<0.01), while it maintained unchanged in the sham group and the control group. BrdU positive cells were observed in tissue section of the transplantion group, and were not found in the other two groups.Conclusion MSCs transplantation has improved cardiac function in adriamycin-induced cardiomyopathy. Neurohumoral regulation possibly plays an important role in active mechanisms of MSCs transplantation on DCM.