自体骨髓单个核细胞经桥血管内移植治疗缺血性心脏病的可行性研究

The Feasibility of Bone Marrow Mononuclear Cells Transplanted into Bypass Graft to Improve Therapeutic Efficiency in Patients with Ischemic Heart Disease

目的:探讨冠状动脉旁路移植手术中自体骨髓单个核细胞经桥血管进行细胞移植的可行性及安全性。方法:选择冠状动脉旁路移植手术患者10例,既往有陈旧性心肌梗死,需要进行冠状动脉旁路移植手术,左心室射血分数(LVEF)≤40%,通过超声心动图、心脏MRI等检查进行心功能评价。患者进行手术同时抽取骨髓血提取单个核细胞,在桥血管远端吻合完成后,分别将单个核细胞经桥血管注射到静止的心肌组织内。术后通过超声心动图、心脏MRI等检查评价心功能。结果:所有患者术后均顺利康复。术中采集骨髓血45～60 mL,分离骨髓单个核细胞(2.8～7.1)×107,连续超声心动图检查发现LVEF术后1周明显升高,术后3个月显著升高,心脏MRI检查发现左心室明显缩小。术中及术后均未见与骨髓血采集以及细胞经冠状动脉桥血管内移植相关的并发症。结论:作为缺血性心脏病的一种辅助性治疗手段,骨髓单个核细胞通过桥血管进行心肌内移植是安全可行的。

Objective：The study was designed to investigate the safety and feasibility of intracoronary artery injection of bone marrow mononuclear ceils through the bypass graft artery during CABG. Methods：Ten patients with old myocardial infarction, LVEF ≤ 40% , and muitipie vessel diseases were enrolled in the study. The bone marrow mononuclear cells were harvested from the bone marrow before the CABG was carried out. And the patients received CABG and cells transplantation through the grafts into arresting heart. The heart function was evaluated with TEE and cardiac MRI before and after the operation. Results：All the 10 patients recovered weli. Bone marrow was harvested from iliac crest 45-60 mL,isolated mononuclear cells （2.8-7.1）×10^7. The heart function improved significantly 1 week and 3 months postoperatively. There was no morbidity associated with bone marrow harvestand cells transplantation. Conclusion： Bone marrow mononuclear ceils transplantation through bypass graft,as an adjunctive therapy,is safe and feasible.