内皮祖细胞对心梗后心衰患者心功能改变的影响

Effect of granulocyte colony stimulating factor EPC on cardiac function in patients with heart failure after myocardial infarction

目的研究应用粒细胞集落刺激因子动员内皮祖细胞治疗心肌梗死后心力衰竭患者心功能的改变。方法选取38例心肌梗死后心衰患者,随机分成治疗组和对照组,治疗组在常规治疗(包括药物和介入治疗)基础上给予内皮祖细胞动员剂G-CSF(600μg/d)静脉注射,连续注射7 d。检测两组治疗前、治疗后第7天和第4个月BNP值及外周血内皮祖细胞数量,行心脏超声检测LVSD、EDV、LVEF。结果治疗组的内皮祖细胞数量较对照组增加明显,尤其第7天增加有显著差异(P<0.01)。两组患者血浆BNP值较治疗前均显著下降恢复正常值(P<0.01);两组心功能指标治疗后均有所好转(P<0.05),治疗组较对照组改善明显(P<0.05),尤以治疗组LVEF值第4个月增加明显,差异有显著性(P<0.01)。结论内皮祖细胞治疗心肌梗死后心衰患者,可有效减轻心室重构,改善心功能。

Objective To study the changes of cardiac function following treatment with granulocyte colony stimulating factor（G-CSF） in patients with heart failure after myocardial infarction.Methods Thirty-eight patients with heart failure after myocardial infarction were randomized into G-CSF treatment group and control group.All the patients received conventional treatment（medication and interventional therapy）,and the patients in treatment group were given additional G-CSF（600 μg/day） for 7 consecutive days.The plasma level of brain-type natriuretic peptide（BNP） and the number of endothelial progenitor cells（EPCs） in the peripheral blood were detected before and at 7 days and 4 months after the treatment.The cardiac functions（LVSD,EDV,and LVEF） were evaluated by ultrasonic imaging before and at 2 weeks and 4 months after the treatment.Results The number of EPCs was significantly higher in the treatment group than in the control group after the treatment especially at 7 days（P0.01）.？ In both groups,BNP level was lowered significantly after the treatment to recover the normal level（P0.01）.The cardiac functions were improved in all the patients at 7 days and 4 months after the treatment,and the improvement was more obvious in the treatment group（P0.05）,？especially in terms of LVEF at 4 months after the treatment（P0.01）.Conclusion EPC mobilization by G-CSF can effectively improve the cardiac functions and lessen ventricular remodeling in patients with heart failure after myocardial infarction.