陈延军,张瑶,尹新华,张烁,李丽丽,于波

• 1: 哈尔滨医科大学附属第二医院
• 2:哈尔滨医科大学附属第二医院
• 3:哈尔滨医科大学附属第二医院
• 4:哈尔滨医科大学附属第二医院

摘要(Abstract)：

目的研究自体骨髓单个核细胞(ABMMNCs)经冠状动脉(冠脉)移植对扩张型心肌病(DCM)患者心功能的影响及其安全性。方法16例扩张型心肌病患者,按患者的意愿分成两组移植组(n=10)在药物治疗的同时,通过冠脉转运将ABMMNCs移植入心肌组织内;对照组(n=6)只进行相关的药物治疗;两组在术前和术后6个月分别行超声心动图及动态心电图检查。结果超声心动图检查显示移植组的左心室射血分数(LVEF)较术前明显增高,左心室舒张末期内径(LVDd)、左心室收缩末期内径(LVSd)较术前明显降低,左心房内径(LAD)也较术前明显降低。而对照组的LVEF,LVDd及LVSd虽然较6个月前有所改善,但差异无统计学意义(P>0.05)。术中及术后随访6~12个月均无恶性心律失常和其他合并症发生。结论ABMMNCs经冠脉移植,可以治疗扩张型心肌病,改善心脏功能,而且较为安全。

关键词(KeyWords)： 骨髓单个核细胞;细胞移植;心肌病,充血性

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 陈延军,张瑶,尹新华,张烁,李丽丽,于波

参考文献(References)：

• [1]Blatt A,Cotter G,Leitman M,et al.Intracoronary administration of autologous bone marrow mononuclear cells after induction of short ischemia is safe and mayimprove hibernation andischemiain patients withischemic cardiomyopathy.Am Heart J,2005,150:986.
• [2]Strauer BE,Brehm M,Zeus T,et al.Regeneration of human in-farcted heart muscle by intracoronary autologous bone marrow cell transplantationin chronic coronary artery disease:the IACTStudy.J AmColl Cardiol,2005,46:1659-1661.
• [3]Tang YL.Autologous mesenchymal stemcells for post-ischemic myo-cardial repair.Methods Mol Med,2005,112:183-192.
• [4]Misao Y,Takemura G,Arai M,et al.Bone marrow-derived myo-cyte-like cells and regulation of repair-related cytokines after bone marrowcell transplantation.Cardiovasc Res,2006,69:476-490.
• [5]Yoo KJ,Li RK,Weisel RD,et al.Heart cell transplantation im-proves heart function in dilated cardiomyopathic hamsters.Circula-tion,2000,102:Ⅲ204-Ⅲ209.
• [6]Yoo KJ,Li RK,Weisel RD,et al.Autologous smooth muscle cell transplantation improved heart function in dilated cardiomyopathy.Ann Thorac Surg,2000,70:859-865.
• [7]Agbulut O,Menot ML,Li Z,et al.Temporal patterns of bone mar-row cell differentiation following transplantation in doxorubicin-in-duced cardiomyopathy.Cardiovasc Res,2003,58:451-459.
• [8]Nygren JM,Jovinge S,Breitbach M,et al.Bone marrow-derived hematopoietic cells generate cardiomyocytes at a low frequency through cell fusion,but not transdifferentiation.Nat Med,2004,10:494-501.
• [9]Kamihata H,Matsubara H,Nishiue T,et al.Implantation of bone marrow mononuclear cells into ischemic myocardium enhances col-lateral perfusion and regional function via side supply of angioblasts,angiogenic ligands,and cytokines.Circulation,2001,104:1046-1052.