中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2010年
29期
16-19
,共4页
张华%宋先忠%王俊生%郑诒章%史芳涛
張華%宋先忠%王俊生%鄭詒章%史芳濤
장화%송선충%왕준생%정이장%사방도
骨髓%细胞移植%心肌梗死%单个核细胞
骨髓%細胞移植%心肌梗死%單箇覈細胞
골수%세포이식%심기경사%단개핵세포
Bone marrow%Cell transplantation%Myocardial infarction%Mononuclear cells
目的 探讨冠状动脉搭桥术时同期行自体骨髓单个核细胞移植对心肌梗死面积的影响.方法 选择心肌梗死患者40例,按随机数字表法分为Ⅰ组和Ⅱ组,每组20例,按下述方法进行研究:Ⅰ组施行冠状动脉搭桥术治疗,Ⅱ组施行冠状动脉搭桥术+自体骨髓单个核细胞移植,移植细胞数为(6.84±2.88)×107个.随访6个月,比较两组的疗效.结果 两组围手术期均无死亡病例发生,随访6个月患者全部存活,无恶性心律失常等主要心脏不良事件发生.术后6个月,Ⅱ组左室射血分数与Ⅰ组比较明显升高[(57.40±5.21)%比(50.75±5.88)%,t=3.79,P＜0.05],NYHA心功能分级与Ⅰ组比较也明显改善[(1.30±0.47)级比(1.85±0.59)级,t=3.27,P＜0.05].单光子发射型计算机体层摄影结果提示Ⅱ组心肌梗死面积较Ⅰ组明显减小,差异有统计学意义[(14.57±5.20)%比(20.45±5.18)%,t=3.59,P＜0.05].结论 冠状动脉搭桥术时同期行自体骨髓单个核细胞移植可有效地缩小心肌梗死面积,使心脏功能得到改善,且安全、可行.
目的 探討冠狀動脈搭橋術時同期行自體骨髓單箇覈細胞移植對心肌梗死麵積的影響.方法 選擇心肌梗死患者40例,按隨機數字錶法分為Ⅰ組和Ⅱ組,每組20例,按下述方法進行研究:Ⅰ組施行冠狀動脈搭橋術治療,Ⅱ組施行冠狀動脈搭橋術+自體骨髓單箇覈細胞移植,移植細胞數為(6.84±2.88)×107箇.隨訪6箇月,比較兩組的療效.結果 兩組圍手術期均無死亡病例髮生,隨訪6箇月患者全部存活,無噁性心律失常等主要心髒不良事件髮生.術後6箇月,Ⅱ組左室射血分數與Ⅰ組比較明顯升高[(57.40±5.21)%比(50.75±5.88)%,t=3.79,P＜0.05],NYHA心功能分級與Ⅰ組比較也明顯改善[(1.30±0.47)級比(1.85±0.59)級,t=3.27,P＜0.05].單光子髮射型計算機體層攝影結果提示Ⅱ組心肌梗死麵積較Ⅰ組明顯減小,差異有統計學意義[(14.57±5.20)%比(20.45±5.18)%,t=3.59,P＜0.05].結論 冠狀動脈搭橋術時同期行自體骨髓單箇覈細胞移植可有效地縮小心肌梗死麵積,使心髒功能得到改善,且安全、可行.
목적 탐토관상동맥탑교술시동기행자체골수단개핵세포이식대심기경사면적적영향.방법 선택심기경사환자40례,안수궤수자표법분위Ⅰ조화Ⅱ조,매조20례,안하술방법진행연구:Ⅰ조시행관상동맥탑교술치료,Ⅱ조시행관상동맥탑교술+자체골수단개핵세포이식,이식세포수위(6.84±2.88)×107개.수방6개월,비교량조적료효.결과 량조위수술기균무사망병례발생,수방6개월환자전부존활,무악성심률실상등주요심장불량사건발생.술후6개월,Ⅱ조좌실사혈분수여Ⅰ조비교명현승고[(57.40±5.21)%비(50.75±5.88)%,t=3.79,P＜0.05],NYHA심공능분급여Ⅰ조비교야명현개선[(1.30±0.47)급비(1.85±0.59)급,t=3.27,P＜0.05].단광자발사형계산궤체층섭영결과제시Ⅱ조심기경사면적교Ⅰ조명현감소,차이유통계학의의[(14.57±5.20)%비(20.45±5.18)%,t=3.59,P＜0.05].결론 관상동맥탑교술시동기행자체골수단개핵세포이식가유효지축소심기경사면적,사심장공능득도개선,차안전、가행.
Objective To study the effects ofautologous bone marrow mononuclear cells (BMMCs)transplantation during coronary artery bypass gafting (CABG) on myocardial infarct size. Methods Forty myocardial infarction patients diagnosed by coronary angiography (CAG) and SPECT and confirmed at surgery were enrolled and randomly assigned CABG alone (group Ⅰ) or CABG with intramyocardial or intracoronary injection of autologous BMMCs (group Ⅱ), 20 cases in each group. Baseline and followed up evaluations included SPECT and NYHA-FC before and after 6 months operation, recorded the major adverse cardiac events (MACE) at the same time. The number of autologous BMMCs injected was (6.84 ± 2.88) ×107 in group Ⅱ. Results There was no procedure-related complication during 6 months followed up in all patients. After 6 months operation,left ventricular ejection fraction in group Ⅱ was significantly higher than that in group Ⅰ [(57.40 ±5.21)% vs. (50.75 ±5.88)%,t =3.79,P＜0.05],NYHA-FC in group Ⅱ was significantly improved than that in group Ⅰ [(1.30 ± 0.47) grades vs. (1.85 ± 0.59) grades, t = 3.27, P ＜0.05],SPECT showed myocardial infarct size in group Ⅱ was significantly lower than that in group Ⅰ[(14.57 ±5.20)% vs. (20.45 ±5.18)% ,P ＜0.05]. Conclusion Autologous BMMCs transplantation during CABG is safe and feasible, which can reduce the myocardial infarct size in patients with myocardial infarction.
