脐血单个核细胞移植治疗冠状动脉性心脏病合并心力衰竭的安全性

Umbilical cord blood mononuclear cell transplantation is safe for treatment of coronary heart disease with heart failure

背景:多项实验和临床研究表明,干细胞移植可能取代坏死心肌、建立新生血管、改善心脏功能,明显改善心血管疾病患者临床症状和预后。目的:观察新生儿脐血单个核细胞移植治疗冠状动脉性心脏病合并心力衰竭患者的安全性。方法:共入选冠状动脉性心脏病合并心力衰竭患者(急性心肌梗死合并心力衰竭6例,陈旧心肌梗死合并心力衰竭6例)12例,入院后在常规药物与介入治疗基础上,经皮经腔导管建立冠状动脉通道,利用微导管移植分离的新生儿脐血单个核细胞悬液。细胞移植后1周进行常规抽血检查,与移植前对比血常规、肝肾功能、免疫指标的变化。结果与结论:脐血单个核细胞移植后有1例发热,不良反应发生率为8.3%,无微栓塞发生,随访1周无移植物抗宿主病发生。与细胞移植治疗前比较,治疗后1周血常规、肝功能、肾功能、C-反应蛋白、IgA、IgG等指标差异无显著性意义。说明新生儿脐血单个核细胞移植治疗冠状动脉性心脏病死合并心功能衰竭在短期是安全的。

BACKGROUND：Number of experimental and clinical studies have shown that stem celltransplantation can establish new blood vessels and improve heart function instead of necrotic myocardium, to significantly improved clinical symptoms and prognosis of cardiovascular disease patients. OBJECTIVE：To observe the safety of human umbilical cord blood mononuclear cells transplantation in patients with coronary heart disease and heart failure. METHODS：A total of 12 patients with coronary heart disease and heart failure （acute myocardial infarction and heart failure in six cases, old myocardial infarction and heart failure in six cases） were enrol ed in this study. Patients were treated on the basis of standard medication and percutaneous coronary intervention. The coronary pathway was established via a percutaneous catheter, and suspension of cord blood mononuclear cells was injected through microcatheter into the distal artery. Routine blood test was carried out at 1 week after celltransplantation, blood routine, liver function, kidney function, C-reactive protein, IgA, IgG were compared preoperatively and postoperatively. RESULTS AND CONCLUSION：The incidence of adverse reactions in cord blood stem celltransplantation was 8.3%, including one case of fever. No micro-embolism occurred. During 1-week fol ow-up, no graft-versus-host disease appeared. After celltransplantation, there were no significant changes in blood routine, liver function, kidney function, C-reactive protein, IgA, IgG. These findings indicate umbilical cord blood monomuclear cells transplantation is safe in a short term for patients with coronary heart disease and heart failure.