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背景:作为成体干细胞的一种,脂肪源性干细胞具有可塑性并且能在特定条件下分化为心肌细胞。将自体脂肪间充质干细胞移植到心肌梗死区域后,能够分化为心肌细胞及血管内皮细胞,构建新的血管故能改善心泵功能。目的:全面了解影响脂肪干细胞向心肌细胞分化及移植的各种因素,以及目前临床及实验室研究中,应用脂肪干细胞移植治疗心肌病的现状。方法:电子检索 MEDLINE (1981-01/2010- 04)、PubMed 数据库,中国生物医学文献数据库(CBM)(1990-01/2010-04)、中文学术期刊全文数据库(CNKI),筛查相关文章的参考文献,主要检索主题词包括“脂肪源性干细胞; 心肌细胞;细胞分化;细胞移植;心肌病治疗”。结果与结论:纳入综述文献 6 篇;试验研究报告 24 篇。目前脂肪源性干细胞的分离培养方法基本统一,已找到有效的体外扩增技术,但尚无直接方法进行干细胞鉴别;脂肪源性干细胞的诱导分化在体内、体外均可进行,并具有早期分化特性,比骨髓间充质干细胞更有利于向心肌细胞的分化;应针对不同类型心肌病选择不同移植方法;干细胞磁标记技术可以对已经植入体内的脂肪源性干细胞进行活体动态监测;自体移植脂肪干细胞是心肌病的一种新的治疗方法,但要将其成功用于临床实践还需找到可以抑制脂肪源性干细胞的促肿瘤细胞特性的方法以保证术后患者的长期安全性。
BACKGROUND: As a kind of adult stem cells, adipose-derived stem cells are malleable and can differentiate into cardiomyocytes under certain conditions. Transplantation of autologous adipose-derived mesenchymal stem cells into myocardial infarction area can differentiate into cardiomyocytes and vascular endothelial cells. Constructing new blood vessels can improve cardiac pump function. OBJECTIVE: To comprehensively understand the various factors that affect the differentiation and transplantation of ADSCs into cardiomyocytes and the status of cardiomyopathy treated with ADSCs in clinical and laboratory studies. METHODS: MEDLINE (1981-01 / 2010-04), PubMed database, Chinese Biomedical Literature Database (CBM) (1990-01 / 2010-04), Chinese Journal Full-text Database (CNKI), and the related articles References, the main search keywords include “fat-derived stem cells; cardiomyocytes; cell differentiation; cell transplantation; cardiomyopathy treatment.” RESULTS AND CONCLUSION: Six articles were included in the review and 24 were included in the study. At present, the method of isolation and culture of adipose-derived stem cells is basically uniform, and effective in vitro amplification techniques have been found, but there is no direct method for stem cell differentiation. Induction and differentiation of adipose-derived stem cells can be performed both in vivo and in vitro with early differentiation characteristics , Compared with bone marrow mesenchymal stem cells is more conducive to the differentiation of cardiomyocytes; different types of cardiomyopathy should be selected for different transplantation methods; Stem cell magnetic labeling technology can be implanted in vivo fat-derived stem cells in vivo dynamic monitoring; autologous fat transplantation Stem cells are a new treatment for cardiomyopathy, but their successful use in clinical practice needs to find ways to inhibit the tumor-promoting properties of adipose-derived stem cells to ensure the long-term safety of postoperative patients.