CAJ | 학술논문

背景:至目前为止发表的心肺复苏论文所使用的基本为健康动物,而临床实际情况是在心肺复苏发生之前患者大多有严重的心脏疾病,并导致了心室颤动的发生.目的:实验力图接近临床实际,观察骨髓间充质干细胞移植后心肌梗死大鼠心功能的变化,及对其心肺复苏结果的影响.设计、时间及地点:随机对照动物实验,于2007-04/08在美国南加州大学和中山大学附属第二医院联合完成.材料:成年SD雄性大鼠18只,随机分为模型对照组、细胞移植组,9只/组.另取1月龄SD大鼠1只用于制备骨髓间充质干细胞.方法:两组大鼠均结扎左前降支冠状动脉建立心肌缺血模型,4周后再次开胸,细胞移植组梗死心肌局部注射PKH26荧光标记的骨髓间充质干细胞悬液0.1 mL(5×106个细胞),模型对照组同法注射等量PBS.4周时诱导心室颤动及进行心肺复苏.主要观察指标:移植后2,4周用超声心动图测量心功能;测量心肺复苏前及心肺复苏后4 h内的血液动力学参数的变化;在心肺复苏72 h后取心肌组织进行病理切片检查.结果:与模型对照组比较,移植后2,4周细胞移植组射血分数均明显升高(P<0.01).在心肺复苏前及心肺复苏后4 h内,与模型对照组比较,细胞移植组心脏指数、左心室收缩压力上升到40 mm Hg(1 mm Hg=0.133 kPa)时的上升速率、左心室舒张速率、左心室舒张末压均有明显改善(P<0.01,P<0.05).与模型对照组比较,细胞移植组大鼠心肺复苏后可生存至72 h,生存时间明显延长(P<0.05).病理切片结果显示心肌内存在大量PKH26标记的骨髓间充质干细胞.结论:大鼠心肌梗死后,骨髓间充质干细胞移植治疗能明显改善其心功能、心肺复苏前后的血流动力学参数以及生存时间.
배경:지목전위지발표적심폐복소논문소사용적기본위건강동물,이림상실제정황시재심폐복소발생지전환자대다유엄중적심장질병,병도치료심실전동적발생.목적:실험력도접근림상실제,관찰골수간충질간세포이식후심기경사대서심공능적변화,급대기심폐복소결과적영향.설계、시간급지점:수궤대조동물실험,우2007-04/08재미국남가주대학화중산대학부속제이의원연합완성.재료:성년SD웅성대서18지,수궤분위모형대조조、세포이식조,9지/조.령취1월령SD대서1지용우제비골수간충질간세포.방법:량조대서균결찰좌전강지관상동맥건립심기결혈모형,4주후재차개흉,세포이식조경사심기국부주사PKH26형광표기적골수간충질간세포현액0.1 mL(5×106개세포),모형대조조동법주사등량PBS.4주시유도심실전동급진행심폐복소.주요관찰지표:이식후2,4주용초성심동도측량심공능;측량심폐복소전급심폐복소후4 h내적혈액동역학삼수적변화;재심폐복소72 h후취심기조직진행병리절편검사.결과:여모형대조조비교,이식후2,4주세포이식조사혈분수균명현승고(P<0.01).재심폐복소전급심폐복소후4 h내,여모형대조조비교,세포이식조심장지수、좌심실수축압력상승도40 mm Hg(1 mm Hg=0.133 kPa)시적상승속솔、좌심실서장속솔、좌심실서장말압균유명현개선(P<0.01,P<0.05).여모형대조조비교,세포이식조대서심폐복소후가생존지72 h,생존시간명현연장(P<0.05).병리절편결과현시심기내존재대량PKH26표기적골수간충질간세포.결론:대서심기경사후,골수간충질간세포이식치료능명현개선기심공능、심폐복소전후적혈류동역학삼수이급생존시간.
BACKGROUND:The majority of published article on cardiopulmonary resuscitation (CPR) used healthy animals. In fact, patients commonly have severe heart diseases before CPR, leading to ventricular fibrillation. OBJECTIVE: To investigate outcome of myocardial function and cardiopulmonary resuscitation in myocardial infarction rats treated with bone marrow mesenchymal stem cells (MSCs) transplantation.DESIGN, TIME AND SETTING: A randomized, controlled animal experiment was performed at the University of Southern California and Second Hospital of Sun Yat-sen University from April to August 2007.MATERIALS: A total of 18 adult male SD rats were randomly divided into model control and cell transplantation groups with 9 animals in each group. In addition, 1 SD rat aged 1 month was used to prepare bone marrow MSCs.METHODS: Myocardial ischemia was induced by ligation of the left anterior descending artery (LAD). Animals respectively received 5×106 MSCs (0.1 mL) marked with PKH26 in phosphate buffer solution (PBS) or PBS alone 4 weeks after LAD ligation. Ventricular fibrillation and CPR were performed 4 weeks after MSCs or PBS injection.MAIN OUTCOME MEASURES: Heart function was evaluated by ultrasound cardiography 2, 4 weeks after transplantation; hemodynamics was measured before and 4 hours following CPR. Myocardial tissues were harvested 72 hours after CPR for pathological exanimation.RESULTS: Compared with model control group, ejection fraction of transplantation group was significantly increased 2 and 4 weeks after transplantation (P<0.01), and cardiac index, dp/dt40, and -dp/dt were significantly improved before and within 4 hours after CPR (P<0.01, P<0.05). Moreover, the rats survived longer in transplantation group (72 hours) after CPR compared with control group (P<0.05). Pathological section results showed a large number of PKH26-1abeled MSCs in the rnyocardium.CONCLUSION: Myocardial function, hemodynamics and survival time after CPR were significantly improved in animals treated with MSCs transplantation.