自体骨髓间充质干细胞移植治疗心绞痛临床研究

Autologous bone marrow mesenchymal stem cell transplantation for angina

目的:评价自体骨髓间充质干细胞移植治疗心绞痛的安全性和有效性。方法:40例心绞痛患者,分为观察组与对照组各20例。观察组在接受常规药物治疗和经皮冠状动脉介入治疗后,行冠状动脉内自体骨髓间充质干细胞移植,对照组仅接受常规药物治疗和经皮冠状动脉介入治疗。2组在术前和术后6个月行二维超声、单光子体层扫描和动态心电图检测;在术中、术后3,6个月观察2组是否有心肌梗死、心律失常等并发症,并评价疗效。结果:观察组心绞痛发作频率、硝酸甘油用量、运动时间及加拿大心血管学会心绞痛分级明显优于对照组(P<0.05)。与对照组比较,观察组灌注缺损明显减小(P<0.01)。2组均无心肌梗死、心律失常及其他不良事件发生。结论:冠状动脉内注射自体骨髓间充质干细胞治疗心绞痛安全有效。

Objective To evaluate the safety and efficacy of autologous bone marrow mesenchymal stem cells transplantation for angina.Methods Forty patients with angina were divided into treatment group（n=20） and control group（n=20）.The treatment group received autologous bone marrow mesenchymal stem cells transplantation following regular medicine therapy and percutaneous coronary intervention.Control group only received regular medicine therapy and percutaneous coronary intervention.Two dimensional echocardiography,single-photon emission computed tomography imaging and ECG Holter monitor were done before and 6 months after the procedure.The complications as acute myocardial infarction and arrhythmia were observed and the efficacy for angina was evaluated intraoperatively,3 and 6 months after the procedure.Results The angina frequency,nitroglycerine usage,exercise time and Canadian Cardiovascular Society class in the treatment group were superior to those in control group（P〈0.01）.Single-photon emission computed tomography showed the perfusion defect in treatment group was smaller than that in control group.No myocardial infarction or arrhythmia occurred during the transplantation in both two groups.There were no serious adverse events in the two groups during and after the procedure.Conclusion Intracoronary transplantation of autologous bone marrow mesenchymal stem cells is safe and effective for angina.