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1、自體骨髓干細(xì)胞移植治療心肌梗死的臨床研究作者：楊承健，張郁青，徐欣，胡世文，曹佳寧，張?jiān)萝?，黃偉，金艷，張馥敏，楊志健【關(guān)鍵詞】骨髓干細(xì)胞;細(xì)胞移植;心肌梗死[摘要]目的研究自體骨髓干細(xì)胞經(jīng)冠脈移植對(duì)心肌梗死患者心功能的影響及其安全性。方法6例冠心病伴心肌梗死患者，男5例、女1例，平均年齡62歲(5廠75歲)，體外分離培養(yǎng)自體骨髓干細(xì)胞2一3周，開通梗死相關(guān)“罪犯”血管，通過(guò)冠脈轉(zhuǎn)運(yùn)將骨髓干細(xì)胞植入患者的心肌梗死區(qū)，移植的骨髓間充質(zhì)干細(xì)胞數(shù)為(0.9一3?2)x106個(gè)，骨髓單個(gè)核細(xì)胞數(shù)為(1?6一5?3)x106個(gè)。術(shù)前和術(shù)后6個(gè)月分別行99mTcMTBT心肌灌注顯像、二維超聲心動(dòng)圖、
2、心電圖和動(dòng)態(tài)心電圖檢查。結(jié)果6例患者二維超聲心動(dòng)圖檢查示左室射血分?jǐn)?shù)(LVEF)較術(shù)前明顯增力口[(52.33±8.70)%vs(42.92±12.60)%,P<0.05],左室舒張期內(nèi)徑(LVDd)較術(shù)前明顯減少[(54.33±4.84)vs(61.67±6.83),P<0.05];6例99mTcMIBI檢查顯示梗死部位心肌灌注明顯改善。術(shù)中及術(shù)后隨訪6~18個(gè)月無(wú)心律失常和其他合并癥發(fā)生。結(jié)論進(jìn)行自體骨髓干細(xì)胞經(jīng)冠脈移植治療冠心病、心肌梗死具有抑制左室重構(gòu)、改善心臟功能的作用。Clinicalresearchfortreatmentofmyocardialinfarcti
3、onwithautologousbonemarrowstemcel1transplantationAbstract:ObjectiveToevaluatetheefficacyandsafetyoftransplantationofautologousbonemarrowmesenchymalstemcelIs(BMSCs)andmononuclearcells(BMMNCs)fortreatingmyocardialinfarction.MethodsSixpatientssufferedfromcoronaryheartdiseasewithmyocardialinfarctionw
4、ereenrolled.In6patientsBMSCs+BMMNCsweretransplantedimmediatelyfollowingPCI.AutologousBMSCs+BMMNCswereisolatedandculturedfor23weeks.BMSCs[(0.93.2)x106]andBMMNCs[(1.65.3)x106]weretransplantedthroughtheintracoroaryway.Cardiacfunctionsweredeterminedby2Dechocardiography,technetium99mmethoxyisobutyliso
5、nitrile(99mTcMIBI)andECGHoltermonitorbeforeand6monthsaftertheprocedure,respectively.ResultsLeftventricularejectionfraction(LVEF)significantlyincreased[(52.33±8.70)%vs(42.92±12.60)%,P<0.05]andleftventriculardiastolicdiameter(LVDd)reduced[(54.33±4.84)vs(61.67土6.83),P&It;0.05].Neitherobviousarrhy
6、thmianorothercomplicationwasobservedduring618monthsfollowupinal16patients.ConclusionsThepreliminarystudyhasshownthatinthepatientssufferedfromcoronaryheartdiseasecomplicatedwithmyocardiacinfarction，transplantationofBMSCs+BMMNCscanimprovecardiacfunctionwithoutsignificantcomplicationsandarrhythmiadu
7、ring618monthsfollowup?Keywords:bonemarrowstemcelIs;cel1transplantation;myocardialinfarction(ModernMedicalJournal,2007,35:710)干細(xì)胞移植為冠心病提供了一個(gè)嶄新的治療途徑。大量動(dòng)物實(shí)驗(yàn)證實(shí)，干細(xì)胞移植可以改善心功能［18］。自體骨髓干細(xì)胞移植因來(lái)源豐富，沒有免疫排斥作用，因而備受臨床醫(yī)師重視［910］。我們與南京
