激光心肌血运重建联合血管内皮祖细胞移植治疗缺血性心脏病

Effect of the Combined Use of Transmyocardial Laser Revascularization and Implantation of Endothelial Progenitor Cells on Canine Ischemic Heart

探讨激光心肌血运重建术(TMLR)联合血管内皮祖细胞(EPCs)移植治疗缺血性心脏病。将18只杂种犬成功建立急性心肌梗塞(AMI)动物模型后随机分为对照组,TMLR组和TMLR+EPCs组,每组6只。TMLR组:AMI后针对缺血区心肌进行激光打孔。TMLR+EPCs组:TMLR术后将EPCs与藻酸钙载体复合物移植入缺血区心肌激光孔道内。术后4周评价心功能和检测缺血区心肌组织新生血管状况。结果表明,TMLR+EPCs组心肌局部收缩力明显高于对照组和TMLR组,心功能明显改善。TMLR+EPCs组激光孔道内有新生血管样结构生长,而TMLR组激光孔道内形成纤维化瘢痕。TMLR+EPCs组较TMLR组激光孔道周围新生血管计数明显增多,并且两组均较对照组明显增多。TMLR联合EPCs及载体复合物移植促进缺血心肌新生血管形成,增加心肌局部收缩力,改善心功能。

Objective to determine the effect of transmyocardial laser revascularization（TMLR） in combined with the implantation of endothelial progenitor cells（EPCs） on cardiac function and neovascularization of myocardial ischemia.An operation of acute myocardial ischemia was created.Afterwards,the dogs were randomized into AMI group,TMLR group and TMLR＋EPCs receiving TMLR with implantation of EPCs and calcium alginate into channels induced by laser.Four weeks later,all dogs underwent echocardiography and the samples of myocardial ischemia tissue underwent histochemical and immunohistologic analysis.The results show that TMLR＋EPCs group regional contractility in the left artial diameter（LAD） territory revealed an improvement versus control and TMLR groups,whereas control and TMLR animals did not show any difference.Neoangiogenesis was observed in laser channels in the canine heart subjected to TMLR＋EPCs treatment,the remains of clacium alginate appeared in the channels of TMLR＋EPCs group,but the fibrosis in TMLR group.The result indicates TMLR in combined with EPCs improve the cardiac regional and global function in acute myocardial ischemia from advancing impariment,and augment neovascularization in channels of ischemic myocardium induced by laser.