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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。方法将移植组和对照组分别经自制的心内膜注射导管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)和无血清培养,移植前后、6周及3个月超声评价左心功能,3个月时取梗死周围心肌组织冷冻切片,免疫荧光法鉴定结蛋白(desmin)和心肌特异性肌钙蛋白I(cTnI)的表达。结果自制的可调节注射导管,制作方法简单,安全有效;MSCs移植数量平均为(3.81±0.09)×107个;左室射血分数正常为(69.3±2.5)%,心肌梗死后降为(34.9±0.9)%,移植后3个月升至(56.7±0.8)%,超声提示室壁运动增强;与对照组相比,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),荧光显微镜下可见DAPI标记胞核为蓝色荧光的移植细胞,免疫组化提示结蛋白及cTnI表达阳性。结论实验用注射导管可以完成细胞的心内膜移植,移植的MSCs体内定位明确,移植后心功能改善,并有心肌相关蛋白的表达。
Objective To investigate the feasibility of endocardial catheterization for stem cell transplantation for myocardial infarction. Methods The transplanted and control groups were treated with home-made intramyocardial instillation of myocardial infarction, respectively. Mesenchymal stem cells (MSCs) and serum-free medium Left ventricular function was evaluated by echocardiography. Myocardial tissue surrounding the infarct was frozen at 3 months and the expression of desmin and cTnI was detected by immunofluorescence. Results The self-made adjustable injection catheter was simple, safe and effective. The average number of MSCs transplanted was (3.81 ± 0.09) × 107, the left ventricular ejection fraction was (69.3 ± 2.5)%, and the level of myocardial infarction was (34.9 ± 0.9%). The level of ventricular wall motion increased to (56.7 ± 0.8)% at 3 months after transplantation. Compared with the control group, the left ventricular end-diastolic pressure, left ventricular end-diastolic pressure and left ventricular pressure (P <0.01). Fluorescence microscopy showed that the cells labeled with DAPI labeled with blue fluorescence were blue fluorescence. Immunohistochemistry showed that the positive expression of desmin and cTnI protein was detected. Conclusions The experimental endocardial transplantation of cells can be accomplished by using the injection catheter. The transplanted MSCs have a clear localization in vivo, improved cardiac function after transplantation, and the expression of myocardial associated protein.