经冠状动脉自体骨髓单个核细胞移植修复梗死心肌的临床研究The clinical study of autologous mononuclear bone marrow cell transplantation repair infarcted myocardium by intracoronary route
高连如,朱智明,王志国,费宇行,徐洪涛,李贤峰,陈宇,田海涛,王浩,曹毅,朱家瑞,贺声,黄友章,张宁坤,王丽华,张军,张云山,沈建良,刘惠亮,丁青艾,杨平地,杨晔
摘要(Abstract)：
目的 观察经冠状动脉 (冠脉 )自体骨髓单个核细胞 (mononuclearbonemarrowcell,MBMC)移植修复梗死心肌、改善心脏功能的可行性、效果、安全性及不良反应。方法 38例急性心肌梗死 (AMI)患者分为细胞移植组 [常规PCI+细胞移植 (n =2 8) ]和对照组 [常规PCI(n =10 ) ]。随访观察 3个月 ,包括临床、实验室指标、二维超声心动图、正电子发射体层心肌显像 (PET) ,4 8h持续心电监测。梯度密度法分离自体MBMC。PCI+MBMC移植或单纯PCI手术在心肌梗死后平均 14 6d进行。2 1例行超选择性移植 ,经梗死相关冠脉、气囊充盈下高压注入 4× 10 6 个MBMC ,重复注入 6～ 8次。 7例经冠脉选择性移植 ,气囊未充盈下高压注入移植细胞 ,细胞数与上相同。结果 2 8例细胞移植患者手术均安全。 3例于细胞注入后 15～ 30min出现发冷反应 ,半小时后好转 ;3例细胞注入时出现短暂自限性室性早搏 ;术后 4 8h持续心电监测未出现新的心律失常。 15例完成移植后 3个月PET随访观察 ,13例 (13 15 ,86 6 7% )显示原梗死代谢缺损区出现有代谢活力心肌 ,平均占原梗死区 (4 0 0 8±8 82 ) %。超声心动图随访 ,MBMC移植组左室射血分数增加 6 83% (P <0 0 1) ,左室每搏输出量增加18 6 3% (P <0 0 5 ) ;而对照组心功能无改善。结论 本?
关键词(KeyWords)： 骨髓单个核细胞 ;急性心肌梗死;移植
基金项目(Foundation):
作者(Author): 高连如,朱智明,王志国,费宇行,徐洪涛,李贤峰,陈宇,田海涛,王浩,曹毅,朱家瑞,贺声,黄友章,张宁坤,王丽华,张军,张云山,沈建良,刘惠亮,丁青艾,杨平地,杨晔
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