自体骨髓干细胞移植治疗心肌梗死6例4年随访

Autologous bone marrow stem cell transplantation for treatment of myocardial infarction in 6 cases: A 4-year follow-up report

选取2003-11／2004-06在同仁医院住院的急性ST抬高性心肌梗死男性患者6例，平均年龄52．5岁，在经皮穿刺冠状动脉球囊成形处理和支架植入血运重建后，经患者及其家属知情同意，进行自体骨髓干细胞移植治疗，移植前1周皮下注射粒细胞集落刺激因子行干细胞动员，外周血CD34＋细胞达到1％～3％时，采集从骨髓动员出来的外周血单个核细胞，进一步纯化后经球囊导管注入梗死相关血管。每半年随访1次，4年后心肌梗死面积在干细胞移植后3个月时平均下降42．7％的基础上进一步缩小8．03％，总梗死面积平均下降50．73％，心脏射血分数增加至55．4％，冠状动脉造影无严重狭窄和需要行血运重建的病变出现。

In order to observe the long term results of clinical safety and effectiveness of treating AMI with autologous bone marrow stem cells transplantation, Six patients with ST segment elevated AMI were followed up for 4 years, who, 52.5 years old in average, were enrolled and performed the treatment at Tongren Hospital from November 2003 to June 2004. Following Percutaneous Transluminal Coronary Angioplasty and stent revascularization performed with recoglization by patients and their family members, patients were subcutaneously injected with granulocyte colony-stimulating factor （G-CSF） for 5 days before transplantation. When CD34＋ cells going up to 1%-3% in the peripberal blood, mononuclear cells in peripheral blood were harvested, purified, and further infused into the infarcted related coronary artery with an over-the-wire balloon catheter. Following up was performed every half a year. Four years later, the infarcted area of these patients was further decreased by 8.03%, in the basic descent of 42,7% at 3 months averagely; total infracted area descent was 50.73%, but ejection fraction increased by 4.6% from 50.8%. There was no serious coronary artery restenosis and/or stenosis formation which need revascularization upon angiography.