自体外周血干细胞移植治疗急性心肌梗死对左心室功能的影响研究

Evaluation of left ventricular function by echocardiography in patients with acute myocardial infarction(AMI)by autologous peripheral blood stem cell transplantation

目的探讨自体外周血干细胞(PBSCs)移植治疗急性心肌梗死(AMI)对左心室功能的影响。方法选择2003年11月至2005年9月辽宁省人民医院收治的69例AMI患者,分成干细胞移植组35例和对照组34例,两组均接受药物和冠状动脉内介入治疗,干细胞移植组在此基础上动员自体骨髓干细胞,进行外周血干细胞移植。两组均于治疗前、治疗后6个月进行超声心动图检查。结果6个月时干细胞移植组心脏收缩末容积(ESV)明显减小(P<0·05);舒张末容积(EDV)无显著性变化(P>0·05);左室射血分数(LVEF)显著增高(P<0·05);左室壁节段性运动积分指数(WMSI)明显减低(P<0·001);对照组于介入术前及术后6个月随访ESV、EDV、LVEF及WMSI差异均无显著性意义;术后6个月随访移植组与对照组比较ESV下降,LVEF升高,WMSI降低(P<0·05)。结论自体外周血干细胞治疗AMI可以在近期有效地缩小缺血梗死面积,减轻左室重构,改善心功能。

Objective To evaluate left ventricular function in patients with acute myocardial infarction （AMI） by autologous peripheral blood stem cells （PBSCs） transplantation with echocardiography. Methods Patients with AMI were randomly assigned to receive intracoronary PBSCs transplantation following bone marrow cells mobilization （ standard drug therapy and PCI, PBSCs transplantation group, n = 35 ） or only receive standard therapy （ standard drug therapy and PCI, n = 34）. Echocardiography were performed before and 6 months after treatment. Results LV function was significantly improved 6 months after G - CSF mobilized autologous PBSCs transplantation compared to baseline （P 〈 0. 05 ）. Left end -systolic volume： P =0.01; WMSI： P 〈0. 0001 while these parameters remained unchanged in the control group. Compared with control group, transplantation group showed decreased ESV, improved EF and decreased WMSI six months after treatment. Conclusion The present study demonstrates that LV function is improved and LV remodeling attenuates in the patients with myocardial infarction after PBSCs transplantation at six -month follow- up.