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目的:探讨应用粒细胞集落刺激因子(granulocyte-colonystimulatingfac-tor,G-CSF)动员自体骨髓干细胞进入心肌梗死部位原位移植以修复梗死心肌组织,对急性心肌梗死患者心肌梗死面积及心功能的影响。方法:25例初次急性心肌梗死患者在入院后随机分为干细胞原位移植组(n=12)和对照组(n=13)。干细胞原位移植组于入院后在常规治疗基础上加用G-CSF动员自体骨髓干细胞进行心肌梗死原位移植;对照组按急性心肌梗死常规方法治疗。于入院第1,28d描记常规12导联心电图,采用Wagner的QRS波群记分法评价心功能,于入院后7,28d行核素心肌灌注断层显像,测量心肌梗死面积。结果:G-CSF治疗4周,干细胞原位移植组QRS记分值明显降低(2.14±0.21),显著低于对照组(5.07±0.31)(t=5.2,P<0.05);心肌梗死面积由(36±8)%下降至(18±6)%,显著小于对照组(33±7)%(t=12.6,P<0.05)。结论:用G-CSF动员自体骨髓干细胞来修复坏死心肌组织的“干细胞原位移植”疗法,能减小心肌梗死的范围,改善心功能。
OBJECTIVE: To investigate the effect of granulocyte-colonystimulatingfac-tor (G-CSF) mobilization of autologous bone marrow stem cells into myocardial infarction site by orthotopic implantation to repair myocardial infarction area and myocardial infarction area and cardiac function in patients with acute myocardial infarction . Methods: Twenty-five patients with initial acute myocardial infarction were randomly divided into three groups: orthotopic transplantation group (n = 12) and control group (n = 13). Stem cell transplantation group in situ after transplantation on the basis of conventional treatment with G-CSF mobilization of autologous bone marrow stem cells for myocardial infarction in situ transplantation; control group according to the conventional method of treatment of acute myocardial infarction. On the first and the 28th days after admission, the conventional 12-lead electrocardiogram was described. Wagner’s QRS complex was used to evaluate the cardiac function. Myocardial perfusion imaging was performed at 7 and 28 days after admission to measure the infarct size. Results: After treated with G-CSF for 4 weeks, the QRS score of stem cell transplantation group was significantly lower (2.14 ± 0.21) than that of control group (5.07 ± 0.31) (t = 5.2, P <0.05) (36 ± 8)% to (18 ± 6)%, which was significantly lower than that of the control group (33 ± 7)% (t = 12.6, P <0.05). CONCLUSIONS: “Stem cell transplantation” therapy using G-CSF to mobilize autologous bone marrow stem cells to repair necrotic myocardium can reduce the range of myocardial infarction and improve cardiac function.