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目的:观察经冠状动脉(冠脉)自体骨髓单个核细胞(mononuclear bone marrow cell,MBMC)移植对急性前壁心肌梗死患者心室重构、心肌组织血流灌注及左心室收缩功能的影响。方法:选取40例急性前壁心肌梗死患者,根据患者的意愿分干细胞移植组(20例,接受急诊经皮冠脉介入治疗+标准药物+经冠脉注入骨髓单个核细胞治疗)和常规治疗对照组(20例,接受急诊经皮冠脉介入治疗+标准药物治疗)。两组患者分别于术前、术后3个月、术后6个月进行6分钟步行实验、多谱勒心脏超声心动图、平衡法核素心血池显像(ENRA),并记录发病6个月内主要临床事件。结果:同常规治疗组相比,心室重构、心肌组织血流灌注及左心室收缩功能术后3个月各项指标两组无明显差异,术后6个月干细胞移植组较常规治疗组改善明显,有显著性差异(P<0.05)。结论:本研究提示自体骨髓单个核细胞经冠脉移植治疗急性心肌梗死是安全的,能改善患者心肌组织灌注、左心室收缩功能及优化心室重构。
Objective: To observe the effect of coronary artery (mononuclear bone marrow mononuclear cells) transplantation on ventricular remodeling, myocardial perfusion and left ventricular systolic function in patients with acute anterior myocardial infarction. Methods: Forty patients with acute anterior myocardial infarction were enrolled in this study. According to the patients’ wishes, they were divided into stem cell transplantation group (20 cases, emergency percutaneous coronary intervention + standard medicine + bone marrow mononuclear cells by coronary injection) and routine treatment control Group (20 cases, receiving emergency percutaneous coronary intervention + standard drug treatment). Two groups of patients were preoperatively, 3 months after surgery, 6 months after 6-minute walk test, Doppler echocardiography, balance method of radionuclide blood pool imaging (ENRA), and record the incidence of 6 The main clinical events during the month. Results: There was no significant difference between the two groups in the indexes of ventricular remodeling, myocardial perfusion and left ventricular systolic function at 3 months postoperatively. Compared with the conventional treatment group, the stem cell transplantation group improved at 6 months Obviously, there was a significant difference (P <0.05). Conclusion: This study suggests that autologous bone marrow mononuclear cells are safe for coronary artery transplantation in patients with acute myocardial infarction, which can improve myocardial perfusion and left ventricular systolic function and optimize ventricular remodeling.