三种途径移植自体BM-MNCs对猪急性心肌梗死后心功能影响的对比研究

Cardiac Function Study of Autologous BM-MNCs by Intramyocardial,Intracoronary and Intravenous Transplantation Into Ischemic Myocardium of AMI in Swines

目的对比研究心肌内、冠脉内及静脉内3种途径移植自体骨髓单个核细胞(BM-MNCs)对猪急性心肌梗死后心功能的影响。方法3种途径移植后4周观察小血管密度及心功能变化情况。结果(1)3种途径BM-MNCs移植后4周小血管密度均明显高于各自的对照组(P<0.01);心肌内移植BM-MNCs组与冠脉内移植BM-MNCs组相比小血管密度无统计学差异,但明显高于静脉内移植BM-MNCs组(P<0.01)。(2)3种途径BM-MNCs移植后4周LVEF及FS均明显高于各自对照组但组间比较无统计学差异;心肌内移植组和冠脉内移植组LVEDd均明显低于对照组,而静脉内移植组LVEDd虽低于对照组但无统计学差异(P>0.05)。结论3种途径移植BM-MNCs均有助于促进缺血心肌血管新生,改善左心室收缩功能,其中心肌内直接注射和冠脉内注射效果相似,静脉注射较前两种途径移植效果差;心肌内与冠脉内移植BM-MNCs组有减轻心室重构的作用,但在静脉移植组该作用不明显。

ObjectiveTo study the effects of autologous bone marrow-derived mononuclear on cardiac function changes cells （BM-MNCs） transplantation by intramyocardial, intracoronary and intravenous. MethodsFour weeks after transplantation, blood vessels density and heart function were observed. Results（1） Blood vessels density in three different deliver BM-MNCs groups were significantly higher than those in control group（P〈0.01）, which in intramyocardial and intracoronary group were not significant but higher than those in intravenous group（P〈0.01）. （2）The values of LVEF and FS in three implantation groups were all higher than those in their control groups. But there was no significance among three implantation group for LVEF and FS. LVEDd in intramyocardial and intracoronary group was lower than that in control group, but there was no significance between intravenous group and control group（P〉0.05）. ConclusionThree ways of implantation can induce angiogenesis in the ischemic myocardium and improve left ventricular systolic function. The therapeutic efficacy is similar in intramyocardial group and intracoronary group, which is better than in intravenous group. Intramyocardial and intracoronary transplantation can attenuate remodeling but these effects can not be observed in intravenous group.