自体外周血内皮祖细胞移植对小型猪心肌缺血再灌注损伤的作用

Effect of autologous transplantation of peripheral endothelial progenitor cells on myocardial ischemia reperfusion injury in mini-swine

目的研究自体外周血内皮祖细胞（EPCs）移植对小型猪心肌缺血再灌注损伤后修复梗死心肌和改善心功能的作用。方法14头小型猪分别采外周血200 mL用于EPCs分离、培养，10-14 d后结扎法建立心肌缺血再灌注损伤模型，随机分为冠状动脉内移植EPCs组[（1.16±1.07）×10^7个细胞/头，n=7]和磷酸盐缓冲液对照组（n=7），比较4周时超声心动图、血液动力学和心肌梗死面积的变化。结果移植4周后，EPCs组左室射血分数（LVEF），室间隔、侧壁、前间壁厚度，心输出量和左室等容收缩压力最大上升速率（＋dp/dtmax）与细胞移植前比较，差异均无统计学意义（P〉0.05）；对照组比移植前LVEF显著降低（0.59±0.07比0.70±0.09），室间隔（0.56±0.05 cm比0.66±0.06 cm）、侧壁（0.52±0.09 cm比0.62±0.05 cm）、前间壁（0.51±0.12 cm比0.70±0.14 cm）显著变薄，心输出量（1.10±0.08 L/min比1.27±0.03 L/min）和＋dp/dtmax[（1.41±0.22）×10^3mmHg/s比（1.76±0.31）×10^3mmHg/s]显著降低，差异均有统计学意义（P〈0.05）；EPCs组较对照组心肌梗死面积显著减小（1.60±0.26 cm^2比4.14±1.30 cm^2，P〈0.05）。结论自体EPCs移植可明显改善心肌缺血再灌注损伤后的左室收缩功能，该作用可能通过减小心肌梗死面积实现。

Objective To investigate the therapeutic effectiveness of autologous transplantation of peripheral endothelial progenitor cells （EPCs） on myocardial ischemia reperfusion injury in mini-swine models. Methods EPCs were isolated from 200 mL peripheral blood of 14 mini-swines individually. Myocardial iscbemia reperfusion injury models were randomized into two groups. After 10 - 14 days culture, （1.16 ± 1.07） × 10^7 EPCs were transplanted by intracoronary artery injection in the EPCs group （n = 7 ）, and phosphate buffer saline were injected in control group （n = 7 ）. Ultrasonic cardiograhpy, hemodynamic parameters and myocardium infarction size were evaluated before and 4 weeks after cell transplantation. Results In the EPCs group, there were no differences in left ventricular ejection fraction （LVEF）, thickness of the intra-ventricular septa, the lateral wall and the anterior wall, cardiac output and ＋ dp/ dtmax ） between before and at 4 weeks after the transplantation （ P 〉 0. 05 ）. In the control group, LVEF, thickness of the intra-ventricular septa, the lateral wall and the anterior wall, cardiac output and ＋ dp/dtmax decreased significantly at 4 weeks after the procedure （ P 〈 0. 05 ）. Transplantation of EPCs minimized the size of myocardial infarction area. Conclusion Transplantation of EPCs into the myocardial iscbemia reperfusion injury area showed beneficial effect on cardiac systolic function. This effect may be achieved due to minimizing the infarction area.