经冠状动脉灌注不同类型的干细胞对慢性心功能不全兔心功能影响的比较研究

Changes of Heart Function after Different Cell Type Stem Cell Transplantation in Chronic Heart Failure

研究非选择性冠状动脉灌注移植干细胞治疗非缺血性心功能不全的可行性;比较自体骨髓单个核细胞(BMCs)、间充质干细胞(MSCs)和成肌细胞(SMs)移植对心功能的影响。使用阿霉素制作兔心功能不全模型,经双球囊封堵主动脉根部后分别灌注自体BMCs、MSCs、SMs和无血清DMEM。比较移植前后左室射血分数(LVEF)及左室舒张末期内径(LVED)变化。结果表明,干细胞移植术中及移植后4周内病死率为7.1%和16.7%。假手术组移植后LVEF有继续恶化的趋势(P>0.05)。移植4周后,BMCs组LVEF明显改善(P<0.05,n=8);MSCs组LVEF有改善的趋势(P>0.05,n=8);SMs组LVEF未见改善(P>0.05,n=6)。假手术组移植后LVED继续扩大(P<0.05);各移植组LVED有继续扩大的趋势(P>0.05)。移植各组心肌组织切片上均发现了存活的移植细胞。移植的BMCs和MSCs表达了肌钙蛋白I。说明,经冠状动脉灌注细胞移植可用于治疗非缺血性心功能不全的实验研究。

To investigate the feasibility of introcoronary cell infusioin into nonischemic heart failure （HF） heart and whether different types of stem cell transplantation would affect heart function to a similar degree. Japanese white ears rabbits were used as HF models by intravenous injection adriamycin. Autologous bone marrow mononuclear cells（BMCs）,bone marrow stromal cells （MSCs）,skeletal myoblasts （SMs） or culture medium were infused into coronary arteries respectively by occluding the root of ascending aorta. The mortality during and 4 weeks after the procedure the mortality was 7. 1% and 16.7% respectively. After 4 weeks, the ejection fraction （EF） in BMCs group had significant improvement（P〈0.05 ,n=8）. No significant difference was seen in MSCs（n = 8）,SMs（n=6） and sham groups（n=8） compared with pretransplantation （P）0. 05）. In sham group,the left ventricular endostolic diameter （LVED） had significant enlargement （P〈0. 05）, No significant difference was seen in MBCs,MSCs and SMs groups compared with pretransplantation （P〉 0. 05）. Immunofluorescence revealed de novo expression of cardiac troponin I in BMCs and MSCs groups, cardiac troponin I was not detected in SMs group. In conclusions, intracoronary cell transplantation could provide effective cell delivery into dilated cardiomyopathy hearts and could be a useful strategy for treating CHF, BMCs cell transplantation may be the first choice in all the above cell types.