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目的 观察骨髓干细胞移植对心力衰竭患者近期心功能的影响。探索一种治疗心力衰竭的新方法。方法 以 3例扩张性心肌病患者为A组 ,抽取骨髓制成干细胞悬液 ,经左、右冠状动脉注入心脏 ;同期收治的风湿性二尖瓣疾病合并全心衰竭患者 7例为B1组 ,于二尖瓣置换术中经左、右冠状动脉及心肌内注射干细胞悬液。既往收治的 10例单纯行瓣膜置换术的风湿性二尖瓣疾病合并全心衰竭患者为B2 组 (对照组 )。分别对三组患者术前、术后 4、8周心脏射血分数 (EF)及心输出量 (CO)进行观察。结果 三组患者均健康存活。A组及B1组患者骨髓干细胞移植后 4周起EF及CO显著提高 (P<0 0 1) ,尤以术后第 8周最为明显 ;与B2 组比较 ,B1组患者干细胞移植后 4周起EF及CO增加显著 (P <0 0 1) ,尤以术后第 8周最为明显。结论 骨髓干细胞移植可明显改善扩张性心肌病患者的心功能 ,而辅助用于风湿性二尖瓣疾病合并全心衰竭患者的外科治疗同样能提高患者术后的心功能。骨髓干细胞移植有望为终末期心衰患者的治疗提供一种新思路。
Objective To observe the effect of bone marrow stem cell transplantation on cardiac function in patients with heart failure. Explore a new way to treat heart failure. Methods A total of 3 patients with dilated cardiomyopathy were selected as Group A, and bone marrow was used to prepare stem cell suspension. The left and right coronary arteries were infused into the heart. In the same period, 7 patients with rheumatic mitral valve disease complicated with heart failure were Group B1, In mitral valve replacement by left and right coronary artery and myocardial injection of stem cell suspension. Previously treated 10 cases of simple valve replacement rheumatic mitral valve disease in patients with congestive heart failure group B2 (control group). The ejection fraction (EF) and cardiac output (CO) of the three groups before and 4 and 8 weeks after surgery were observed. Results All three groups survived healthily. In group A and group B1, EF and CO significantly increased at 4 weeks after transplantation of bone marrow stem cells (P <0.01), especially at 8 weeks after operation; compared with B2 group, B1 and 4 weeks after stem cell transplantation EF and CO increased significantly (P <0.01), especially after 8 weeks of the most obvious. Conclusion Bone marrow stem cell transplantation can significantly improve the cardiac function in patients with dilated cardiomyopathy, and the surgical treatment of patients with rheumatic mitral valve disease complicated with heart failure can also improve the postoperative cardiac function. Bone marrow stem cell transplantation is expected to provide a new idea for the treatment of patients with end-stage heart failure.