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目的 研究自体骨髓间充质干细胞 (BMSCs)和单个核细胞 (BMMNCs)经冠状动脉 (冠脉 )移植对冠心病、心肌梗死患者心功能的影响及其安全性。方法 10例冠心病伴心肌梗死患者 ,通过冠脉转运将BMMNCs植入心肌梗死区 ,术前和术后 6个月分别行99mTc MIBI心肌灌注显像、二维超声心动图及动态心电图检查。结果 3例患者因心肌梗死罪犯血管狭窄小于 5 0 %未行经皮冠状动脉介入术 (PCI) ,仅移植干细胞。余 7例患者在梗死相关冠脉开通后注入干细胞。 10例患者二维超声心动图检查示左心室射血分数 (LVEF)较术前平均增加 10 5 % (4 0 %～ 18% ) ,左心室舒张末期内径(LVDd)较术前平均减少 2 2mm(- 4mm～ 8mm) ,99mTc MIBI显示梗死部位心肌灌注明显改善。术中及术后随访 6～ 12月均无心律失常和其它合并症发生。结论 自体BMSCs和MMNCs经冠脉移植治疗冠心病心肌梗死 ,可以抑制左心室重构 ,改善心脏功能。
Objective To study the effects and safety of transplanting autologous bone marrow mesenchymal stem cells (BMSCs) and mononuclear cells (BMMNCs) through coronary artery (coronary artery) transplantation in patients with coronary heart disease and myocardial infarction. Methods Ten patients with coronary heart disease and myocardial infarction were implanted with myocardial graft via coronary artery. The myocardial perfusion imaging, two - dimensional echocardiography and ambulatory electrocardiogram were performed before and 6 months after operation. Results Three patients were only transplanted with stem cells undergoing percutaneous coronary intervention (PCI) due to less than 50% vascular stenosis. More than seven patients were infused with stem cells after infarction-related coronary artery opening. Two-dimensional echocardiography showed that the left ventricular ejection fraction (LVEF) increased by 10 5% (40% -18%) and left ventricular end-diastolic diameter (LVDd) decreased by 2 2 mm (- 4mm ~ 8mm), 99mTc MIBI showed significant improvement of myocardial perfusion at infarction. Intraoperative and postoperative follow-up 6 to 12 months no arrhythmia and other complications occurred. Conclusion Autologous BMSCs and MMNCs can be used to treat myocardial infarction in coronary heart disease by coronary artery transplantation, which can inhibit left ventricular remodeling and improve cardiac function.