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目的探讨心内膜注射导管应用于干细胞移植治疗心肌梗死的可行性。方法将移植组和观察组分别经导管注射梗死心肌内移植体外扩增的自体骨髓间充质干细胞(mesenchymal stem cells,MSCs)和生理盐水,移植前后、6周及3个月超声评价左心功能。结果 MSCs移植数量平均为(3.81±0.09)×107个;左室射血分数正常对照组为(69.3±2.5)%,心肌梗死后降为(34.9±0.9)%,移植后3个月升至(61.9±1.8)%,超声提示室壁运动增强;与观察组相比,移植组左室收缩末压、左室舒张末压及左室压力最大上升/下降速率改善更明显(均为P<0.01)。结论进行自体骨髓干细胞经冠脉移植治疗冠心病、心肌梗死具有抑制左室重构、改善心脏功能的作用。
Objective To investigate the feasibility of endocardial catheterization for stem cell transplantation for myocardial infarction. Methods The transplanted group and the observation group were transplanted with autologous bone marrow mesenchymal stem cells (MSCs) and normal saline, respectively, which were transplanted into infarcted myocardium by catheterization. The left ventricular function was evaluated by echocardiography 6 weeks and 3 months after transplantation . Results The mean number of MSCs transplanted was (3.81 ± 0.09) × 107. The left ventricular ejection fraction was (69.3 ± 2.5)% in control group and decreased to (34.9 ± 0.9)% after myocardial infarction. After 3 months, (61.9 ± 1.8)%, and ultrasound enhanced wall motion. Compared with the observation group, left ventricular end-systolic pressure, left ventricular end-diastolic pressure, and left ventricular maximum pressure rise / descent rate were significantly improved (all P < 0.01). Conclusions Autologous bone marrow stem cells can be used to treat coronary heart disease by coronary artery transplantation. Myocardial infarction can inhibit left ventricular remodeling and improve cardiac function.