经冠状动脉注入自体骨髓单个核细胞的临床研究

Effects of intracoronary autologous bone marrow mononuclear cells transplantation in patients with anterior myocardial infarction

目的评价经冠状动脉内注射自体骨髓单个核细胞治疗心肌梗死患者的有效性。方法共有35例前壁心肌梗死患者入选本项前瞻性、非随机、开放试验(其中20例患者为细胞移植组,15例为对照组)。两组患者均接受标准的介入治疗和药物治疗,细胞移植组的20例患者同时接受自体骨髓单个核细胞移植。两组患者均接受3个月的临床随访及6MIN步行试验、超声心动图、心肌双核素和心脏核磁等检查。结果3个月的检查结果提示,细胞移植组患者的左室射血分数与常规治疗组相比有显著统计学意义。同时细胞移植组患者的室间隔中段室壁运动位移和左室收缩末容积也有明显改变,细胞移植组显著增加代谢可恢复心肌区占左室的比例。结论经冠状动脉注入自体骨髓单个核细胞可以促进心肌梗死患者左室功能恢复和心肌灌注改善。

Objectives To investigate the efficacy of intracoronary transfer of autologous bone marrow mononuclear cells （ABMMNCs） to patients with myocardial infarction （MI） on left ventricular function and myocardial perfusion. Methods Thirty-five patients with MI （ 〉4 weeks） were enrolled in this prospective, open-labeled study （20 patients in cell transplantation group; 15 patients in control group）. All patients were treated by standard drug therapy and percutaneous coronary intervention （PCI）. Baseline and 3 months follow-up evaluations included complete clinical and laboratory examinations, six minutes walk test, echocardiography, Dual-isotope simultaneous acquistion single photon emission computed tomography （DISA-SPECT） and cardiac magnetic resonance imaging （MR]）. Results Baseline parameters were similar between the two groups. NYHA classification and six minutes walk test at 3 months follow-up were also similar between the two groups. However, left ventricular ejection fraction （LVEF） determined by echocardiography and DISA-SPECT was significantly higher; regional wall motion measured by echocardiography and cardiac MRI, myocardial viability and myocardial perfusion in the infarct zone assessed by DISA-SPECT were all significantly improved than before transplantation and than that in control group at 3 months follow-up. Conclusions Our results indicate that intracoronary transplantation of ABMMNCs could improve the left ventricular systolic function and beneficially affect myocardial perfusion up to 3 months pest transplantation in patients with myocardial infarction.