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经冠脉移植骨髓单个核细胞治疗心肌梗死的实验研究(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2006年第3期
页码:
253-257
栏目:
基础研究
出版日期:
2006-06-25

文章信息/Info

Title:
Experimental studies on intracoronary bone marrow mononuclear cells transplantation into the ischemic myocardium
作者:
郑昕;  陈纪林;  胡奉环;  杨伟宪;  杨跃进;  陈在嘉
中国协和医科大学 阜外心血管病医院冠心病诊治中心，北京 100037
Author(s):
ZHENG Xin;  CHEN Ji-lin;  HU Feng-huan;  YANG Wei-xian;  YANG Yue-jin; CHEN Zai-jia
Department of Coronary Heart Disease, Cardiovascular Institute and Fuwai Hospital, CAMS and PUMC, Beijing 100037，China
关键词:
骨髓干细胞;  移植;  心肌梗塞; 心功能;  血管新生
Keywords:
bone marrow stem cell;  transplantation;  myocardial infarction;  heart function;  angiogenesis
分类号:
R542.22
DOI:
-
文献标识码:
A
摘要:
目的 观察经皮冠状动脉内移植自体骨髓单个核细胞于急性心肌梗死区域后的定植、生长、分化特点和疗效。方法中华小型猪冠状动脉前降支结扎90 min再灌注制备心肌梗死模型，分为移植组和对照组，于心肌梗死后1周分别经皮冠状动脉内移植PKH26 标记的骨髓单个核细胞和等体积培养基。心肌梗死后6周通过血流动力学和超声心动图指标检测心功能变化并进行病理检查。结果 在移植了骨髓细胞的梗死区域内可找到发出红色荧光的移植细胞，其VIII因子和Desmin免疫组化染色均为阳性；HE 染色、PTH染色及透射电镜下可观察到幼稚的心肌细胞，未见细胞融合现象。移植组的血流动力学指标显示心肌梗死6周时，较结扎后左室舒张末压显著改善（P<0.05）,较同期对照组左室压力最大上升速度显著升高（P<0.05）；心肌梗死6周时的超声心动图指标和对照组相比，各项指标均无显著差异，术后术前射血分数的差值显著高于对照组(P<0.05)；其梗死区的小血管数量显著高于对照组（P<0.01）。结论 经冠状动脉移植的骨髓单个核细胞可定植于心肌梗死区，并向心肌细胞和血管内皮细胞方向分化，同时能显著地促进小血管再生，有改善心功能的潜能。
Abstract:
AIM To study the engraftment, growth, differentiation and the effect of porcine autologous bone marrow mononuclear cells (BM-MNCs) after being intracoronarily transplanted into acute myocardial infarction (AMI) region. METHODS A 90minute left anterior descending coronary (LAD) artery occlusion followed by reperfusion was used to produce AMI in swine. (8-10)×107 BM-MNCs labeled with PKH26 previously (transplantation group, n=7) or culture medium of the same volume (control group, n=7) were intracoronarily infused into infarction related artery 1 week after AMI. Six weeks after MI, morphologic, histological and immunohistochemical characteristics and heart function were studied. RESULTS In the specimens of transplantation group, the labeled cells were found in the infracted region. Newborn cardiac cardiomyocytes were found by HE stain, PTH stain and transmission electromicroscope. Immunohistochemical stain showed that the PKH26 positive cells were also factor Ⅷ and Desmin positive. In transplantation group, left ventricular enddiastolic pressure measured 6 weeks after operation increased respectively in comparison with those measured after LAD ligation. Left ventricular +dp/dtmax measured 6 weeks after operation increased respectively （P<0.05） compared with those in control group. The echocardiographic parameters showed no difference compared with those in control group and the change (between 6 weeks after operation and before operation) of ejection fraction increased respectively （P<0.05） compared with those in control group. The number of vessels was higher than that of the control group （P<0.01）. CONCLUSION Autologous bone marrow mononuclear cells after being intracoronarily transplanted into AMI region can engraft, grow and differentiate into cardiomyogenic cells and endothelial cells. Intracoronarily transplantation of BM-MNCs can promote angiogenesis and has clinical potential in improving heart function.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2005-06-28.通讯作者：陈纪林，教授，主要从事冠心病研究 Tel:88398044 Email:jilin,chen@263.net 作者简介：郑昕，主治医师，博士 Tel：（010）88398778 Email：zhengxin314@yahoo.com.cn
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