自体骨髓单个核细胞移植治疗冠心病心力衰竭的临床研究

A clinical study of intracoronary autologous bone marrow mononuclear cells transplantation in coronary disease patients with heart failure

目的:评价经冠状动脉内注射自体骨髓单个核细胞治疗冠心病心力衰竭患者的有效性。方法:82例冠心病心力衰竭患者随机入选本项前瞻性、对照试验(其中49例患者为细胞移植组,33例为常规治疗组)。2组患者均接受标准药物治疗,细胞移植组49例患者同时接受自体骨髓单个核细胞移植。1年后随访临床情况及超声心动图、单光子放射计算机断层显像术和血浆脑钠肽测定结果,比较2组治疗前后心功能指标和心肌灌注缺损区面积。结果:细胞移植组与常规治疗组比较,左室射血分数增加,心肌灌注缺损面积降低,血浆脑钠肽下降,差异均有统计学意义(P<0.05)。结论:经皮冠状动脉内移植骨髓单个核细胞治疗冠心病心力衰竭,能有效改善左室收缩功能和心肌灌注。

Objective：To investigate the clinical outcome of intracoronary transfer of autologous bone marrow mononuclear stem cells （BMMSCs） in coronary disease patients with heart failure. Method：There were eighty-two patients enrolled randomly in this prospective, controlled trail （49 patients in cell transplantation group; 33 patients in conventional therapy group）. All patients received conventional treatment and patients in cell transplantation group received autologous BMMSCs. Baseline and 1 year follow-up evaluations included clinical setting, echocardiography, single-photon-emission computed tomography （SPECT）, and the measurement of level of plasma brain natriuretic peptide （BNP）, which were used to reflect the heart function and the myocardial perfusion defect area in both groups. Result： During and after the procedure of cell delivery there were no complication occured. Compared with conventional therapy group, the LVEF increased, the size of myocardial perfusion defect decreased, the plasma level of BNP decreased significantly in patients of cell transplantation group （P〈0.05）. Conclusion： It is safe and feasible that percutaneous transcoronary transplantation of autologous BMMSCs used in coronary disease patients with heart failure for improving the left ventricular systolic function and myocardial perfusion.