急诊经冠状动脉自体骨髓单个核细胞移植治疗急性心肌梗死的临床研究Efficacy of emergent intracoronary transplantation of bone marrow mononuclear cells for treatment of acute myocardial infarction (TCT-STAMI)
李延林,葛均波,钱菊英,史剑慧,王齐兵,牛玉宏,潘翠珍,樊冰,刘学波,张少衡,孙爱军,邹云增
摘要(Abstract)：
目的评价急诊经冠状动脉内骨髓细胞移植治疗急性心肌梗死是否可行。方法20例发病在24h内的急性心肌梗死患者随机分成骨髓移植组(n=10)和对照组(n=10),分别在急诊经皮冠状动脉介入治疗(PCI)成功后3h内经导管注入自体骨髓单个核细胞或安慰剂至梗死相关冠状动脉。随访患者PCI术后1周及6个月左室射血分数(LVEF)、左心室舒张末期内径(LVDd)以及心肌灌注缺损指数。结果经胸心脏超声提示移植组LVEF由术后1周53.8%±9.2%升至58.6%±9.9%(P<0.05),而对照组无显著变化(58.2%±7.5%比56.3%±3.5%,P>0.05);随访移植组LVDd维持不变(52.5±2.8mm比52.1±3.2mm,P>0.05),而对照组LVDd由术后1周50.4±6.0mm增加至55.2±7.1mm(P<0.05)。单光子放射计算机断层显像术(SPECT)提示移植组心肌灌注缺损指数由21±11降低至13±10(P<0.01),而对照组变化不显著。结论急诊经冠状动脉自体骨髓单个核细胞移植可以显著改善急性心肌梗死患者远期左心室收缩功能和心肌血流灌注,并有效防止远期左心室扩大。
关键词(KeyWords)： 心肌梗死;造血干细胞移植;心室功能
基金项目(Foundation):
作者(Author): 李延林,葛均波,钱菊英,史剑慧,王齐兵,牛玉宏,潘翠珍,樊冰,刘学波,张少衡,孙爱军,邹云增
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