微创法联合导入骨髓间充质干细胞及碱性成纤维细胞生长因子基因促进急性心梗后冠脉侧支新生

Basic fibroblast growth factor expressing mesenchymal stem cells by minimally invasive therapy for acute myocardial infarction

目的观察经冠脉联合导人骨髓间充质干细胞及碱性成纤维细胞生长因子基因促进急性心梗后冠脉侧支新生。方法开胸结扎法制作小猪急性心肌梗死模型（17只），1周后行冠状动脉造影，随机分为3组，分别经冠脉导人生理盐水10ml（对照组），10ml含1×10^7MSCs的生理盐水（实验A组），含1×10^7MSCs的生理盐水10ml和pcDNA3-bFGF2000μg（实验B组）；同时行心脏超声检查测定左室收缩功能。心梗后5周再次行冠状动脉造影及心脏超声检查，处死动物后通过病理切片光镜观察，免疫组化染色进行血管计数，观察猪急性心肌梗死恢复期缺血区血管新生及心功能恢复情况。结果所有动物均成功建立急性心肌梗死模型，心梗后1周左室射血分数明显下降，5周后冠脉造影显示实验B组冠脉侧支生长明显，病理切片及免疫组化结果也显示实验B组新生血管明显，实验组心功能较对照组改善。结论联合导入骨髓间充质干细胞及碱性成纤维细胞生长因子基因可促进梗死区血管新生，改善心功能。

Objective Observe neogenesis of blood vessels in coronary by treat with autologous bFGF- expressing bone marrow mesenchymal stem cells in myocardial infarction model. Methods Establish animal models for acute myocardial infarction （AMI） by using LAD ligation way in swine. And divided into three groups 7 days later： control group,MSCs treatment group （1 ×10^7 ）, bFGF-expressing MSCs （1 ×10^7 and 2000 ug）. Using ultrasound cardiography determined heart function. Selective coronary angiography was performed again to observe branch stem neogenesis 5 week later. Then, animals were sacrificed and perfused, immunohistochemistry was performed according to routine method. The numbers of newborn vessels and the survival cells at the site of myocardial infarction was counted. Results Acute myocardial infarction model were sucefful, EF was lower after myocardial infarction 7 days, selective coronary angiography and Immunohistochemistry showed that the numbers of blood vessels in the groups of MSCs and bFGF-expressing MSCs were better than the control group four weeks post operation, EF in MSC group were better than that of contral group. Conclusion Combine bFGF-expressing MSCs treatment improved markedly the neogenesis of blood vessels of injured myocardium and improve the cardiac function.