复合bFGF缓释支架结合骨髓间充质干细胞移植对心梗后血管新生的研究

Experimental study of slow-release stent of bFGF and bone marrow stem cells implantation in myocardial infarction

目的:探讨心肌机械钻孔结合复合碱性成纤维细胞生长因子(bFGF)的缓释支架及骨髓间充质干细胞(BMSCs)移植对心肌血运重建的作用。方法:建立猪急性心梗模型后,于缺血区进行直径3.0mm的透壁性钻孔再生血管术(drilling transmyocardial revascularization,TMDR)并置入等直径的缓释支架,在孔道周围分五点进行细胞移植。心梗模型建立后0.5h及术后6周行心肌核素显像检测。取术后6周的心肌标本进行病理组织学检测。结果:术后6周,与对照组相比,治疗组的新生血管密度及心肌局部血流灌注均显著增加(P<0.001),联合治疗组中上述指标明显高于支架或细胞单独治疗组(P<0.05)。免疫荧光结果显示,联合治疗更有利于移植细胞存活,存活细胞分化成血管内皮细胞,参与新生血管网的形成。结论:复合bFGF的缓释支架及BMSCs移植可引发强烈的血管生成效应,减轻并改善缺血缺氧造成的心肌损伤,增强细胞移植的效果。

Objective：To investigate the effects of drilling transmyocardial revascularization （TMDR） with slow-release stent of bFGF and bone marrow derived stem cell（BMSCs） transplantation on myocardium revascularization. Methods： Mini-swine was randomly assigned to establish models of acute myocardial infarction, subsequently received TMDR, stent implantation and cells transplantation in the infarction territory. Six weeks postoperatively, pathologic histology analysis was performed. Results：Six weeks post operatively vascular density was significantly improved in treated groups compared with control group（P〈0. 001） ;moreover, combined group showed further improvement than that of groups with stent implantation or cells transplantation alone（P〈0. 05）. Histologically, cells were observed to differentiate into endothelial cells. Conclusion：Slow-release stent of bFGF and BMSCs transplantation can greatly promote neovascularization formation.