核磁共振显像评价粒细胞集落刺激因子对心肌梗死后左心功能的影响

Evaluation of Effects of Granulocyte-Colony Stimulating Factor on Left Ventricular Function by Delayed-Enhancement Myocardial Magnetic Resonance Imaging Analysis in Patients with Acute Myocardial Infarction

目的:用延迟增强核磁共振心肌灌注扫描(CMR)评价急性心肌梗死后注射粒细胞集落刺激因子(G-CSF)对梗死后左室功能的影响。方法:选取2008年1月-2009年1月收治的22例急性心肌梗死患者,入院后均接受急性心肌梗死的常规治疗(包括药物与介入治疗),在此基础上随机分成G-CSF治疗组和对照组,G-CSF治疗组除常规治疗外还给予G-CSF(商品名:惠尔血,600μg·d-1)连续注射5d,两组均在心肌梗死后第7天和6个月进行心脏CMR检查,测量患者的左室舒张末期容积和收缩末期容积,计算左室射血分数。结果:对照组左室射血分数在心肌梗死后7d时为(55.58±5.93)%,在心肌梗死后6个月时为(55.77±7.55)%;治疗组左室射血分数在心肌梗死后7d时为(54.16±11.29)%,在心肌梗死后6个月时为(56.43±9.49)%。两组左室射血分数在心肌梗死后6个月时与7d时比较均有增加,但治疗组左室射血分数增加较对照组增加明显,差异有统计学意义(P=0.0047)。结论:急性心肌梗死后注射G-CSF能显著改善心功能。CMR能够用作客观评价心肌梗死后左室功能的方法。

Objective：To evaluate the effect of granulocyte colony stimulating factor （G-CSF） on left ventricular function after acute myocardial infarction （AMI） by using the delayed enhanced myocardial magnetic resonance imaging （CMR） method. Methods： Twenty-two patients with the first onset of AMI, 18 males, 4 females, aged≤75 and treated with emergent percutaneous coronary intervention （PCI） were randomly divided into 2 groups： G-CSF treated groups, which were injected with G-CSF （600 μg/d） for 5 days after the PCI and control group, which were injected with vehicle. CMR was conducted twice at 1 week and 6 months after AMI. Results： 6 months later, the left ventricular ejection fraction （LVEF） in control group was ele vated from 55.58± 5. 93% at 1 week to 55.77± 7.55%; the LVEF in G-CSF treated group was increased from 54. 16±11.29% at 1 week to 56.43 ± 9.49%. The absolute value of increases in LVEF was significantly higher in G-CSF treated group than in control group （P=0. 0047）. Conclusion： Treatment with G-CSF significantly improves ventrieular function after AMI. CMR may be used as an essential tool to evaluate cardiac functions.