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目的探讨两次细胞移植治疗大面积心肌梗死患者的疗效。方法35例大面积急性心肌梗死患者(LVEF<40％),成功实施急诊PCI术后3-7 d,行uRI及SPECT后,随机分为3组。A组11例单次细胞移植组患者于PCI术后3-7 d施行细胞移植,B组12例两次细胞移植组患者分别于PCI术后3-7 d及术后3个月接受细胞移植, 12例对照组患者在相同时间接受0．9％氯化钠溶液冠脉内注射。结果随访12个月时,未发现与重复细胞移植相关的不良反应。MRI结果发现,与对照组相比,单次移植组和两次移植组LVEFF变化值均显著升高[(2．9±2．0)％比(7．1±1．5)％比(11．7±2．7)％,P<0．01],而两次移植组较单次移植组变化更为显著(P<0．01)。同时,MRI显示两次移植组梗死心肌面积、SPECT显示心肌灌注面积改善幅度均优于其他两组(P<0．01)。结论两次骨髓干细胞移植治疗对于大面积急性心肌梗死患者是安全可行的,可在一次移植的基础上进一步改善心脏功能。
Objective To investigate the curative effect of two cell transplantation in patients with large area myocardial infarction. Methods Thirty-five patients with acute myocardial infarction (LVEF <40%) were enrolled in this study. The patients were successfully treated with uRI and SPECT after 3-7 days after PCI. A group of 11 patients with single cell transplantation group were treated with cell transplantation 3-7 days after PCI, and 12 cases of double cell transplantation group B received cell transplantation 3-7 days after PCI and 3 months after PCI , And 12 patients in the control group received intracoronary injection of 0.9% sodium chloride solution at the same time. Results At follow-up of 12 months, no adverse reactions associated with repeated cell transplantation were found. The results of MRI showed that compared with the control group, the changes of LVEFF in single and two groups were significantly increased [(2.9 ± 2.0)% vs (7.1 ± 1.5)% ( 11.7 ± 2.7)%, P <0.01], while the changes in the two transplantation groups were more significant than those in the single transplantation group (P <0.01). At the same time, MRI showed myocardial infarction area in two transplantation groups, SPECT showed that myocardial perfusion area improvement rate was better than the other two groups (P <0.01). Conclusions Two bone marrow stem cell transplantation treatments are safe and feasible for patients with large-area acute myocardial infarction, and can further improve cardiac function on the basis of one transplant.