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目的:探讨经皮经心内膜心肌注射移植猪自体骨髓间充质干细胞(bone marrow mesenchymal stem cells,BM-SCs)的治疗心肌梗死(MI)实验方法的可行性和安全性。方法:选5只雌性健康小型猪通过股动脉入路采用冠脉球囊封堵冠状动脉左前降支60 min建立MI模型。以超声确定MI后两周,采用心肌注射器经心内膜向心肌内注入1×108个小型猪自体红色荧光染料Dil标记的BMSCs,并观察心电图(ECG)的变化。移植BMSCs 8周后,取心肌组织行病理切片,选取含有移植细胞的切片行免疫荧光染色。结果:4只小型猪成功地建立MI模型(1只因术中室颤死亡)并完成经心内膜的细胞移植,注射过程可出现一过性室性早搏以及短阵室速。通过心肌免疫荧光染色证实,移植的BMSCs已在宿主心肌内存活。结论:使用心肌注射器经心内膜心肌移植自体BMSCs创伤小,方法可行,具有临床应用的前景。
Objective: To investigate the feasibility and safety of percutaneous endocardial myocardial transplantation of porcine bone marrow mesenchymal stem cells (BM-SCs) in the treatment of myocardial infarction (MI). Methods: Five female healthy miniature pigs were selected to establish MI model by coronary artery occlusion of the left anterior descending artery of the coronary artery for 60 min via femoral artery approach. Two weeks after the MI was confirmed by ultrasound, 1 × 108 small porcine autologous red fluorescent dye-Dil-labeled BMSCs were injected into the myocardium through the endocardium with a myocardial syringe, and the changes of the electrocardiogram (ECG) were observed. Eight weeks after the transplantation of BMSCs, the myocardial tissue was taken for pathological examination and the sections containing the transplanted cells were selected for immunofluorescence staining. RESULTS: Four miniature pigs successfully established MI model (one died of intraoperative ventricular fibrillation) and completed transcardiac endocardial transplantation. One-ventricular premature beats and transient VT occurred during injection. Cardiac immunofluorescence staining confirmed that the transplanted BMSCs had survived in the host myocardium. CONCLUSION: Traumatic endocardial myocardial transplantation of autologous BMSCs using a cardiac syringe is less invasive and feasible. It has the potential of clinical application.