脐血干细胞移植对缺血性心肌病患者体内炎症因子的影响

Influence of transplantation of human umbilical cord blood stem cells on inflammatory factors in patients with ischemic cardiomyopathy

目的初步探讨人脐血干细胞(HUCBSC)对缺血性心肌病(ICM)患者体内炎症因子的影响。方法选择自2010年4月至2013年12月期间于湖北医药学院附属太和医院心内科确诊缺血性心肌病的患者29例,其中男性17例,女性12例。冠状动脉移植组7例,外周静脉移植组8例,对照组14例。对照组:规范的药物治疗;外周静脉移植组:规范的药物治疗+经外周静脉移植HUCBSC;冠状动脉移植组:规范的药物治疗+经冠状动脉移植HUCBSC。分别记录3组在0月(治疗后当天)、1月、3月、6月检测的C反应蛋白(CRP)、白介素6(IL-6)、肿瘤坏死因子α(TNF-α)、B型脑钠肽(BNP)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治疗后第1月、第3个月和第6个月BNP下降更为明显,差异有统计学意义(P均>0.05)。三个组在0月、1月、3月、6月等4个时间点,血浆IL-6水平、C反应蛋白、TNF-α均呈逐渐下降的趋势,但3组间比较差异无统计学意义(P均>0.05)。结论经外周静脉和冠状动脉途径移植HUCBSC治疗ICM未诱发炎症反应,是一种安全有效的治疗方法。

Objective To investigate initially the influence of transplantation of human umbilical cord blood stem cells （HUCBSC） on inflammatory factors in patients with ischemic cardiomyopathy （ICM）. Methods ICM patients （n=29, male 17 and female 12） were chosen from Apr. 2010 to Dec. 2013, and divided into intracoronary transplantation group （n=7）, peripheral venous transplantation group （n=8） and control group （n=14）. The control group was treated with normative drugs, peripheral venous transplantation group, with normative drugs＋peripheral venous transplantation of HUCBSC and intracoronary transplantation group, with normative drugs＋intracoronary transplantation of HUCBSC. The changes of C-reactive protein （CRP）, interleukin-6 （IL-6）, tumor necrosis factor-α（TNF-α） and B-type natriuretic peptide （BNP） were recorded respectively in 3 groups after 0 m （the same day of treatment time）, 1 m, 3 m and 6 m. Results Compared with control group, BNP decreased significantly in other 2 groups after 1 m, 3 m and 6 m （all P〈0.05）. The levels of IL-6, CRP and TNF-αhad a descending trend after 0 m, 1 m, 3 m and 6 m in 3 groups but the difference had no statistical significance among 3 groups （all P〉0.05）. Conclusion Venous transplantation of HUCBSC and intracoronary transplantation of HUCBSC have not induce inflammation reaction in treatment of ICM, which are safe and effective therapies.