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干细胞移植治疗心肌梗死已有10余年历史,目的在于增加支架介入或冠脉搭桥治疗基础上的获益。细胞种类的选择是决定疗效的关键,大致可分为“第一代”和“第二代”干细胞。“第一代”是谱系非选择性干细胞,分自体和异体,早期阳性结果居多,近年多为中性结果。“第二代”是纯化干细胞,通过细胞表面标记分选出特定细胞谱系,即心脏干细胞,进行定向分化,在II期临床试验中展现获益。另外,近来诱导多能干细胞i PSC成为研究热点。目前干细胞直接心肌再生的证据很少,越来越多的研究肯定其旁分泌作用。
Stem cell transplantation for the treatment of myocardial infarction has more than 10 years of history, the purpose is to increase the benefits of stenting or coronary artery bypass grafting. The choice of cell type is the key to determine the efficacy, can be divided into “first generation ” and “second generation ” stem cells. “The first generation ” is a lineage of non-selective stem cells, sub-autologous and allogeneic, mostly positive early results in recent years, mostly neutral results. “The second generation ” is a purified stem cell that differentiates specific cell lineages, known as cardiac stem cells, from cell surface markers for targeted differentiation and demonstrates benefit in Phase II clinical trials. In addition, the induction of iPSCs from pluripotent stem cells has recently become a research hotspot. At present there is little evidence of direct myocardial stem cell regeneration, more and more research affirmed its paracrine role.