自体骨髓单个核细胞移植治疗陈旧性心肌梗死并心力衰竭的研究

Autologous bone marrow mononuclear cell transplantation on old myocardial infarction complicated with heart failure

目的:观察自体骨髓单个核细胞移植治疗陈旧性心肌梗死并心力衰竭的有效性、安全性。方法:18例陈旧性心肌梗死合并心力衰竭的患者每例取自体骨髓分离骨髓单个核细胞经冠脉途径或心外膜下注射途径进行细胞移植,选同期住院的符合入选标准梗死部位及罪犯血管与移植组相匹配的常规治疗的患者18例为对照组,随访3～6月。结果:移植组患者术后无新的心律失常、心绞痛及心肌梗死发生;与术前比较,NYHA心功能分级改善(P=0.002);6-MWT增加(P=0.005);BNP降低(P=0.000);LVEF增加(P=0.000);WMSI降低(P=0.032),SPECT显示缺损面积缩小(P=0.001),而对照组各项指标虽然也有一定改善,但未显示统计学意义(P>0.05)。结论:自体骨髓单个核细胞移植治疗陈旧性心肌梗死并心力衰竭安全有效。

Objective：To assess the safety and effects of autologous bone marrow stem cell（ABMSC） transplantation in patients with heart failure due to previous myocardial infarction.Methods：Eighteen patients with congestive heart failure due to OMI at least three months ago were taken as the target population.ABMSC were isolated and transplanted by ways of intra-coronary artery or epicardium injection.18 patients which matched for study population in ejection fraction,infarct localization,and infarct size were as control group.All patients were followed-up for 3~6 months.Results：The implantation group patients had no new arrhythmia,angina pectoris and myocardial inflammation that occurred after ABMSC transplantation.Compared with that before transplantation,the mean NYHA functional class was improved（P=0.002）,6-minute walking tests increased（P=0.005）,BNP decreased（P=0.000）.LVEF was increased（P=0.000） and WMSI decreased（P=0.032）.SPECT showed that the infarction area decreased（P=0.001）.In contrast,the control group all indexes only slightly increased,but show no significance（P0.05）.Conclusion：ABMSC transplantation in patients with heart failure due to previous myocardial infarction is safe and effective.