脐血干细胞移植治疗对缺血性心肌病患者左室重塑的影响

Effect of cord blood stem cell transplantation therapy for left ventricular remodeling of patients with ischemic cardiomyopathy

目的初步探讨人脐血干细胞移植治疗对缺血性心肌病患者左室重塑的影响。方法选择湖北医药学院附属太和医院心内科2010年4月-2013年12月确诊为缺血性心肌病的患者29例,根据治疗情况分为对照组（14例）、外周静脉移植组（8例）和冠状动脉移植组（7例）：对照组给予规范的抗心衰药物治疗;外周静脉移植组和冠状动脉移植组在药物治疗的基础上分别经外周静脉和冠状动脉移植人脐血干细胞。分别记录各组在0、1、3、6个月时体内脑钠肽（BNP）、左心室内舒张末期内径（LVEDD）、左心室射血分数（LVEF）等观察指标的变化。结果与对照组比较,外周静脉移植组和冠状动脉移植组1个月后BNP开始下降,3个月和6个月后,BNP下降均更为明显,差异有统计学意义（P〈0.05）,而外周静脉移植组和冠状动脉移植组组间差异无统计学意义（P〉0.05）。与对照组比较,冠状动脉移植组治疗1个月后LVEF值增加,差异有统计学意义（P〈0.05）,各组LVEF值在第3个月和第6个月时,差异无统计学意义（P〉0.05）。三组LVEDD各时点比较差异无统计学意义（P〉0.05）。结论经外周静脉和冠状动脉移植人脐血干细胞治疗缺血性心肌病能协助改善左室重塑,是一种安全有效的治疗方法,可作为一种辅助治疗方式。

Objective To explore the effect of cord blood stem cell transplantation therapy for left ventricular remodeling of patients with ischemic cardiomyopathy. Methods Total 29 cases of patients diagnosed as ischemic cardiomyopathy in Department of Cardiology, Taihe Hospital Affiliated to Hubei University of Medicine from April 2010 to December 2013 were selected, they were divided into control group（14 cases）, peripheral vein transplantation group（8 cases）and coronary artery transplantation group（7 cases） according to the specific treatment. The control group was given standard anti heart failure drugs; based on which, peripheral vein transplantation group and coronary artery transplantation group were respectively given transplantation of human umbilical cord blood cells through peripheral veins and coronary artery. The changes of brain natriuretic peptide（BNP）, left ventricular end-diastolic dimension（LVEDD）, and left ventricular ejection fraction（LVEF） of all groups in 0, 1, 3, 6 months were recorded respectively. Results Compared with the control group, BNP concentration in peripheral vein transplantation group and coronary artery transplantation group began to decline in the first month, it was decreased more significantly in the third and sixth month, the differences were statistically significant（P〈0.05）, while there were no statistically significant differences between peripheral vein transplantation group and coronary artery transplantation group（P〉0.05）. Compared with control group, LVEF in coronary artery transplantation group after treatment for one month was increased significantly（P〈0.05）, while there were no significant differences of LVEF after treatment for 3, 6 months among the three groups（P〉0.05）. There were no statistically significant differences of LVEDD at all time among the three groups（P〉0.05）. Conclusion The therapy of transplantation of human umbilical cord blood cells through peripheral veins and coronary artery for ischemic cardiomyopathy may help to improve left ventricular remodeling, which is a safe and effective therapy and can be as a way of adjuvant therapy.