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目的探讨心肌细胞移植对心肌梗死大鼠的左心室收缩功能的改善作用。方法将65只雄性Wistar大鼠随机分为试验组、对照组和假手术组。试验组(n=25)和对照组(n=25)均结扎冠状动脉左前降支,建立慢性心肌梗死模型。4周后,试验组于心肌梗死区与正常心肌交界处移植新生鼠的心肌细胞；对照组采用与试验组同样方式注射细胞培养液基质；假手术组(n=15)开胸后不结扎冠状动脉,不进行细胞移植。心肌梗死后4周和细胞移植后4周,均采用组织多普勒技术结合二维超声心动图测量大鼠心脏的左室收缩末期容积(ESV)、舒张末期容积(EDV)、左室前壁舒张末期厚度(LVAWD)、左室射血分数(LVEF)及短轴缩短率(FS)、左室短轴乳头肌水平测量前壁和后壁心肌收缩期峰值速度(Sm)和峰值位移(TTs),心尖四腔观测量二尖瓣环平均Sm。用免疫组织化学技术检测试验组心肌移植细胞的存活情况。结果心肌细胞移植后4周,试验组与对照组相比,EDV和ESV均显著缩小(P＜0．01),LVAWD、LVEF、FS、左室前壁和后壁Sm、TTs及二尖瓣环平均Sm均显著增加(P＜0．01)。二尖瓣环平均Sm与左室射血分数呈正相关(r=0．87,P=0．001)。免疫组织化学检测显示试验组心肌疤痕区边缘有移植心肌阳性细胞存在。结论心肌细胞移植能显著改善心肌梗死大鼠左心室收缩功能,逆转左心室重构。
Objective To investigate the effect of myocardial cell transplantation on left ventricular systolic function in myocardial infarction rats. Methods Sixty-five male Wistar rats were randomly divided into experimental group, control group and sham operation group. The experimental group (n = 25) and the control group (n = 25) ligation of the left anterior descending coronary artery, the establishment of chronic myocardial infarction model. After 4 weeks, the experimental group was transplanted into neonatal rat cardiomyocytes at the junction of myocardial infarction area and normal myocardium. The control group was injected with the same medium as the test group. Sham operation group (n = 15) Arteries, without cell transplantation. The left ventricular end-systolic volume (ESV), end-diastolic volume (EDV), left ventricular anterior wall (LVEDF) and left ventricular end-diastolic pressure were measured by tissue Doppler and 2D echocardiography at 4 weeks after myocardial infarction and 4 weeks after cell transplantation. (LVAWD), left ventricular ejection fraction (LVEF) and short axis shortening (FS), systolic peak velocity (Sm) and peak displacement (TTs) of anterior and posterior wall of left ventricular short axis ), Apical four-chamber view of mitral annulus average Sm. Immunohistochemistry was used to detect the survival of myocardial cells in experimental group. Results Compared with the control group, EDV and ESV were significantly decreased (P <0.01), LVAWD, LVEF, FS, Sm, TTs in the anterior and posterior walls of the left ventricle and mitral valve The mean Sm of rings was significantly increased (P <0.01). Mitral annulus mean Sm was positively correlated with left ventricular ejection fraction (r = 0.87, P = 0.001). Immunohistochemistry showed that cardiac muscle cells were positive in the experimental group at the margin of myocardial scar area. Conclusions Myocardial cell transplantation can significantly improve left ventricular systolic function and reverse left ventricular remodeling in rats with myocardial infarction.