比较早期和晚期骨髓单个核细胞移植对猪急性心肌梗死后左室重构的影响

Comparison of effects of early and late bone marrow mononuclear cells transplantation on left ventricular remodeling after acute myocardial infarction in swines

目的对比观察猪急性心肌梗死后早期（1周）和延期（3个月）进行的骨髓单个核细胞移植对心肌梗死后左室重构的影响。方法前降支球囊封堵法成功建立15头猪急性心肌梗死模型，随机均分为对照组、早期移植组和延期移植组。造模1周后急性移植组行自体骨髓单个核细胞移植，对照组注射1640培养基10ml作为对照；造模3个月后延期移植组行自体骨髓单个核细胞移植，造模后1周、造模后3个月、造模后6个月各组分别行心脏超声和SPECT检测，超声检查分析左室舒张末期内径，SPECT分析左室舒张末期容积、射血分数。结果造模6个月后延期移植组的LVd值[（54．20±3．70）mm]低于对照组[（63．20±5．63）mm]，但高于早期移植组[（47．40±1．14）mm]；EDV值[（163．00±6．96）ml]低于对照组[（209．40±18．69）ml]，但高于早期移植组[135．40±4．93）ml]；EF值（O．25±0．02）高于对昭组（0．19±0．02），但低于早期移植组（0．37±0．02）。结论猪急性心梗3月后骨髓干细胞移植的有效抑制左室重构的进一步恶化，但其疗效不如早期移植组。

Objective To compare the effects on left ventricular remodeling of bone marrow mononuclear cells transplantation one week and three months after acute myocardial infarction. Methods Acute myocardial infarction models were successfully established in 15 swine, which were randomly divided into three groups ： placebo group, early transplantation group and late trasplantation group. One week after model had been established, early transplantation group underwent bone marrow mononuclear cells transplantation, and then so did the late trasplantation group three months after acute myocardial infarction. B-ultrasound and single photon emission computed tomography （SPECT） examinations were performed to assess the left ventricular end diastolic dimension（ LVd）, left ventricular end diastolic volume i EDV） and left ventrieular ejection fraction（EF） before and one week, three months, six months after acute myocardial infarction. Results The LVd of late transplantation group [ （54. 20 ± 3.70） mm ] was lower than placebo group [ （63.20 ± 5.63 ） mm ], but higher than early transplantation group [ （47.40 ± 1.14 ） mm ]. The EDV of late transplantation group [ （ 163.00 ±6. 96）ml] was lower than placebo group [ （209.40 ± 18.69）ml], but higher than early transplantation group [ （135.40 ± 4. 93 ）ml]. The EF of late transplantation group （0. 25 ± 0.02） was higher than placebo group （0. 19 ±0.02）, but lower than early transplantation group （0. 37 ± 0. 02）. Conclusions Bone marrow mononuelear cells transplantation can alleviate progressing ventrieular remodeling, even it is performed three month after acute myocardial infarction, but its therapeutic effects are inferior to early transplantation＇s.