骨髓干细胞动员对急性心肌梗死后左室重构影响的临床研究

Clinical study of the effects of bone marrow stem cell mobilization on left ventricular remodeling after acute myocardial infarction

目的 :观察骨髓干细胞动员对急性心肌梗死 (AMI)患者左室重构的影响。方法 :4 8例AMI患者随机分为动员组 (2 5例 )和对照组 (2 3例 ) ,动员组连续 3d给予粒细胞集落刺激因子 (G CSF) 30 0 μg/d ,用2 0 1Tl静息—再分布心肌显像比较两组第 6d、 30d的梗死面积 ,超声心动图观察 72h内和 3个月的左室舒张末期容积指数 (LVEDVI)、收缩末期容积指数 (LVESVI)、室壁运动指数 (WMSI)、射血分数(LVEF)。结果 :动员组治疗后心肌梗死面积明显减少 (0 383± 0 0 77vs 0 5 6 1± 0 0 96 ,P <0 0 1) ,LVESVI减少 [(2 7 4 7± 7 86 )ml/m2 vs (34 5 0± 8 0 8)ml/m2 ,P <0 0 5 ],WMSI减少 (1 10± 0 11vs 2 2 6±0 14 ,P <0 0 1) ,LVEF增加 (0 5 9± 0 0 7vs 0 4 8± 0 0 7,P <0 0 1)。结论 :应用G

Objective To investigate the effects of infarct size and left ventricular remodeling by mobilizing bone marrow stem cell in patients with acute myocardial infarction （AMI）. Methods： 48 patients with AMI were randomly divide into two groups： mobilized group （n = 25）was treated with Granulocyte colony-stimulating factor （GCSF）300μg once a day subcutaneously for 3 days, control group （ n = 23）. At 6th day and 30th day after AMI, the infarct size was measured by t201Tl SPECT. Within 72hs and at 90th day, left ventricular end diastolic volume index （LVEDVI）, systolic volume index （LVESVI）, wall motion score index （WMSI）, ejection fraction （LVEF） were detected. Results： In mobilized group, the infarct size was smaller （ P 〈 0.01 ）, LVESVI and WMSI were significantly decreased （ P 〈 0.05 - 0.01 ）, LVEF was increased after treatment （ P 〈 0.01 ）. Conclusion： Bone marrow stem cell mobilized by G-CSF can reduce the infarct size and prevent and treat left ventricular remodeling after AMI.