自体骨髓单个核细胞移植对急性前壁心肌梗死患者心功能的影响

The study of the treatment of acute myocardial infarction (AMI) by transplanting autologous mononuclear bone marrow cell through intracoronary route

目的观察经冠状动脉自体骨髓单个核细胞(MBMC)移植对急性前壁心肌梗死患者心功能的影响。方法选取40例急性前壁心肌梗死患者,根据患者的意愿分为干细胞移植组(20名,接受急诊PCI+标准药物+经冠脉注入骨髓单个核细胞治疗)和常规治疗对照组(20名,接受急诊PCI+标准药物治疗)。两组患者分别于术前、术后3个月、术后6个月进行6min步行试验、多普勒心脏超声、平衡法核素心血池显像(ERNA),并记录发病6个月内主要临床事件。结果同对照组相比,6min步行试验、超声心动图、ERNA术前与术后3个月两组差异无统计学意义(P>0.05),术后6个月移植组心功能改善明显(P<0.05),差异有统计学意义。结论自体骨髓单个核细胞经冠脉移植治疗急性心肌梗死近期可以改善患者心功能。

Objective To investigate the possibility,safety and efficacy of the repair of infraeted myocardium and improvement of cardiac function by transplanting autologous mononuelear bone marrow cell （MBMC） through intracoronary route in patients with AMI, Methods Fourty patients with AMI were enrolled in this open prospective negative trabant control study and divided into PCI＋drug＋eell transplantation group and PCI ＋drug group.Basellne and follow up evaluations included floor walking test in 6 min,doppler eehocardiogram and ERNA emission computerized tomographie of heart before and 3month,6 month after operation,recorded the MACE at the same time. Results All transplantation surgery were safe. 6 patients had limited ST segment elevation in leads associated with inserted artery and 2 patients temporary cardiac enzymes elevation, floor walking test in 6 min cardiac infarction inpatients were improved：ejective fraction （EF） increased and better wall motion by echocardiogram and ECT.But in control group cardiac function was not improved obviously. Conclusion Present study demonstrates that intracoronary transplantation of autologous MBMC is safe and effective.The marked therapeutic effect may be attributed to MBMC associated myocardial regeneration and neovascularization as well as the action of cytokines and growth factors.