经冠状动脉自体骨髓单个核细胞移植治疗扩张型心肌病的临床研究

Intracoronary Transplantation of Autologous Bone Marrow Mononuclear Cells in Patients With Idiopathic Dilated Cardiomyopathy

目的:观察经冠状动脉骨髓单个核细胞移植治疗扩张型心肌病的疗效和安全性。方法:扩张型心肌病患者17例,心功能NYHAⅢ～Ⅳ级。局部麻醉下以髂后上棘为穿刺点多点穿刺抽取骨髓,经密度梯度离心法获取骨髓单个核细胞,经冠状动脉左前降支注入。细胞移植后观察并随访患者症状、心功能和心血管事件。结果:细胞移植后6个月左心室射血分数由细胞移植前0.34±0.08提高到0.39±0.07,有统计学意义(P<0.05),但左心室收缩末径、舒张末径、室间隔厚度未见明显改变。同时,患者的心功能NYHA分级提高Ⅰ～Ⅱ级。结论:经冠状动脉自体骨髓单个核细胞移植治疗扩张型心肌病是安全的且有一定的疗效。

Objective：To evaluate reliability and efficacy of introcoronary transplantation of autologous bone marrow mononuclear cells in patients with idiopathic dilated cardiomyopathy（DCM）. Methods： The experiment group consists of 17 patients （ NYHA Ⅲ-Ⅳ ） with dilated cardiomyopathy in our hospital. Marrow mononuclear cells were isolated by Ficoll density gradient centrifugation. As catheter went into the coronary ateries, cell suspension was gently injected into the left anterior descending coronary artery （ LAD ）. The patients were followed up for their symptoms, heart function and cardiovascular events. Results ： Left ventricular ejection fraction was elevated by 6% （ P 〈 0.05 ） at 6 months after procedure. Left ventricular diameter of the diastole, left ventricular diameter of the systole and intervenetricular septum thickness had no significant changes compared with the baseline （ P 〉 0. 05 ）. Their NYHA was improved by Ⅰ to Ⅱ classes. Conclusion： Autolognos bone marrow stem cells transplantation can help to improve cardiac function in patients with DCM, and it is safe and effective.