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目的对比观察经皮腔冠状动脉内自体骨髓间充质干细胞(BMMSCs)移植与支架置入术治疗冠心病并心力衰竭的效果。方法自体骨髓干细胞移植组(干细胞组)26例,将备好的自体BMMSCs悬液经心导管自冠状动脉注入缺血或梗死区及其周围心肌;支架置术入组(支架组)30例,经皮腔冠状动脉内置入支架。对比观察2组治疗后3个月患者症状改善、心脏形态和功能变化。结果2组治疗后均无死亡,无低心排综合征、新的心肌缺血及恶性心律失常;2组治疗3个月后,心绞痛发作次数较治疗前均明显减少(P<0.01),心功能提高Ⅰ~Ⅱ级,生活质量明显改善;与治疗前相比,治疗后3个月左心室收缩末直径均缩短(P<0.05),心脏收缩速度(干细胞组P<0.01,支架组P<0.05)、射血分数(干细胞组P<0.01,支架组P<0.05)及心排血量(P<0.01)均明显提高;2组间对比差异无统计学意义(P>0.05)。结论经皮冠状动脉内途径自体BMMSCs治疗冠心病并心力衰竭是安全、有效、可行的;它与冠状动脉内支架置入术相比,近期疗效无差异。
Objective To compare the effects of transplanting autologous bone marrow mesenchymal stem cells (BMMSCs) transplanting and stenting in patients with coronary heart disease and heart failure. Methods Twenty-six cases of autologous bone marrow stem cell transplantation group (stem cell group) were injected with autologous BMMSCs into the ischemic or infarct area and the surrounding myocardium via transcatheter arterial catheterization. Thirty patients (group) Percutaneous transluminal coronary stent implantation. The changes of symptoms and heart shape and function in the two groups were observed 3 months after treatment. Results No death, no hypothalamic syndrome, new myocardial ischemia and malignant arrhythmia were found in the two groups. After 3 months of treatment, the number of angina pectoris was significantly decreased in both groups (P <0.01) and heart Compared with before treatment, left ventricular end systolic diameters were shortened (P <0.05), systolic velocity (S <0.05, P < 0.05), ejection fraction (P <0.01 in stem cell group, P <0.05 in scaffold group) and cardiac output (P <0.01). There was no significant difference between two groups (P> 0.05). Conclusion Percutaneous intracoronary autologous BMMSCs are safe, effective and feasible in the treatment of coronary heart disease and heart failure. Compared with coronary stenting, there is no difference in short-term efficacy.