自身干细胞移植治疗老年顽固性心力衰竭的临床研究

A clinic study of the therapeutic effects of the self-stem cell transplantation in the elder patients

目的探讨应用自身干细胞移植治疗对老年顽固性心力衰竭（CHF）的临床疗效、心功能分级、运动耐量的影响。方法将60例CHF患者随机分成治疗组（30例）和对照组（30例）。对照组口服稳定剂量的利尿剂、地高辛、ACEI或ARB、B阻滞剂、治疗糖尿病药物（胰岛素、格列奇特、二甲双胍）、他汀类药及抗高血压药物（非洛地平缓释片等）；治疗组在此基础上连续3d皮下注射重组粒细胞集落刺激因子，复查血常规WBC〉3万／mm3后，应用美国血技公司产MC＋干细胞单采机，分离3--4h干细胞25-30ml，常规seldinger法穿刺右股动脉行常规冠状动脉造影后5F微管置入，冠状动脉主干分叉处将自身外周血分离的干细胞直接缓慢注入（5～10min）。结果治疗组自身干细胞移植前后比较心衰症状明显改善，心功能测定LVEDD、6min步行距离、心肌耗氧量峰值均有显著改善（P〈0．05）。结论自身干细胞移植能明显改善CHF患者的心功能状态和临床症状，提高运动耐量。

Objective To study the clinic effect of self-stem cell transplantation in the treatment of chronic heart failure （CHF） on the elder patients. Methods 60 cases of chronic heart failure were randomly divided into two groups. The patients in the control group （n=30） were individually given the routine treatment of CHF （diuretics, digoxin, ACEI and control blood sugar）.In the study group （n=30）, besides the above routine treatment, self-stem ceils obtained from peripheral blood were transplanted in coronary bifurcation lesions. Results It was obviously improvement in the LVEDD, the six-min-step walking examination and NYHA heart function classification. The therapeutic effect was significantly different between the two groups （P〈0.05）. Conclusion Self-stem cell transplantation is a safe and effective method in treating CHF patients due to the much improvement of the heart function and exercise tolerance.