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目的:观察多次静脉移植骨髓间质干细胞治疗心肌梗死的可行性及对心肌梗死后心功能的影响。方法:骨髓间质干细胞培养传至5代后,制备成终浓度为4×109个/L的悬液备用。将40只SD大鼠均结扎冠状动脉左前降支,建立急性心肌梗死模型后,随机分为3组:①对照组(10只):只静脉注射0.85%氯化钠溶液;②静脉移植组(15只):心肌梗死模型制备后24h,从尾静脉注射骨髓间质干细胞0.5ml(含2×109个/L)连续7d;③心外膜移植组(15只):心肌梗死模型制备后1~3h,于梗死周边区(心肌颜色苍白区周边)分6点注射骨髓间质干细胞,每点50μl。5周后,观察3组的生存情况及心脏的结构功能。结果:心肌梗死对照组有3只大鼠死亡,其他组无死亡。与对照组相比,静脉移植组、心外膜移植组的左室结构与功能明显改善(P<0·05),静脉移植组与心外膜移植组差异无统计学意义(P>0·05)。结论:骨髓间质干细胞可以在体外大量扩增,异体输入无不良反应,静脉注射与直接心肌注射无明显差别,方法可行。
Objective: To observe the feasibility of multiple intravenous transplantation of bone marrow mesenchymal stem cells in treatment of myocardial infarction and its influence on cardiac function after myocardial infarction. Methods: BMSCs were cultured and passaged to passage 5 for a final concentration of 4 × 109 cells / L. All 40 SD rats were ligated with left anterior descending branch of coronary artery. After establishment of acute myocardial infarction model, they were randomly divided into three groups: ① control group (n = 10): only 0.85% sodium chloride solution intravenously; ② vein graft group 15): 24h after myocardial infarction model was prepared, 0.5ml bone marrow mesenchymal stem cells (including 2 × 109 cells / L) were injected into tail vein for 7 days continuously; ③ epicardium transplantation group (15 rats): myocardial infarction model 1 ~ 3h, bone marrow mesenchymal stem cells were injected into the peri-infarct area (the periphery of the pale myocardium area) at 6 o’clock, each point was 50μl. After 5 weeks, the survival of the three groups and the structural function of the heart were observed. Results: Three rats died in the myocardial infarction control group and none died in the other groups. Compared with the control group, the left ventricular structure and function of the vein graft group and the epicardium transplantation group were significantly improved (P <0.05), and there was no significant difference between the vein graft group and the epicardium transplantation group (P> 0 · 05). Conclusion: Bone marrow mesenchymal stem cells can proliferate in vitro with no adverse reactions after allogeneic input. There is no significant difference between intravenous injection and direct intramyocardial injection. The method is feasible.