自体骨髓单个核细胞心肌移植对猪慢性缺血心肌心功能的影响

Effect of cardiac transplantation of autologous bone marrow mononuclear cells on cardiac function of swine with chronic ischemic myocardium

目的:探讨自体骨髓单个核细胞心肌移植对猪慢性缺血心肌心功能的改善作用。方法:实验于2005-01/2005-10在香港大学动物实验中心进行。①取健康巴马小型猪17只,开胸后在左回旋支起始部放置Ameroid环。②将存活的16只巴马小型猪随机分成2组,自体骨髓单个核细胞移植组9只,对照组7只。术后4周在C型臂X射线机的引导下心肌定位注射导管进入左心室,移植组猪于心肌缺血部位注射自体骨髓单个核细胞,将细胞总数为1.5×108的细胞悬液1.5mL进行15个点的注射,每个点注射0.10mL。对照组按照同样的方法注射相同数量的生理盐水。③移植后4周进行心脏超声检查,检测心脏功能。结果:17只猪中1只因肺部感染于术后21d死亡,其余16只均进入结果分析。①猪第1次手术后1月左右冠状动脉造影显示左冠状动脉回旋支均闭塞,左前降支通畅。②心脏M型超声检查显示移植组左室侧后壁运动较对照组明显增强,二维超声心动图检查显示移植组较对照组室壁明显增厚、运动度增强。移植组较对照组的心功能有明显改善。结论:自体骨髓单个核细胞心肌移植可改善慢性缺血心肌的心功能,可用于缺血性心脏病的治疗。

AIM： To investigate the improving effect of intramyocardial transplantation of autologous bone marrow mononnclear cells on the cardiac function of swine with chronic ischemic myocardium. METHODS：The experiment was carried out in the Animal Experimental Center of University of Hong Kong from January 2005 to October 2005.① Experimental swines underwent thoracotomy and placement of an Ameroid constrictor on the left circumflex branch of coronary artery. ②Sixteen survived swines were randomly divided into 2 groups： autologous bone marrow mononuclear cells transplantation group （n=9） and control group （n=7）. Four weeks after operation, injection catheter was put into the left ventricle through cardiac location by the direction of X-ray machine with C-type arm. Autologous bone marrow mononuclear cells were injected into the cardiac ischemic site of the swine of the transplantation group. 1.5 mL cell suspension containing 1.5×10^8 cells was injected at 15 points with 0.10 mL in each one. Same volume of normal saline was injected in the swines of the control group with the same methods. ③Another four weeks later, cardiac function was examined hy echocardiography. RESULTS： Among 17 swines, one died of lung infection 21 days af- ter operation, the other sixteen swines entered the stage of result analysis. ① Coronary arteriongraphy showed that left circumflex branches of left coronary artery were obstructed and anterior descending branches were unobstructed after one month of the first operation ②M-model echocardiography of heart showed that movement of posterior and latero wall of heart of transplantation group was significantly strengthened compared with those of control group. Two-dimensional echocardiography showed that the thickening and movement of posterior and latero wall of heart of transplantation group was significant compared with those of control group. There was significant improvement of cardiac function in the transplantation group as compared with that in the control group. CONCLUSION：Transplantation of the autologous bone tharrow mononuclear cells can improve the cardiac function of swine with chronic ischemic myocardium, and be used in the treatment of ischemic heart disease.