CAJ | 학술논문

目的探讨急性心肌梗死患者自体骨髓干细胞冠状动脉内注射改善心功能的治疗中血管内皮细胞生长因子(VEGF)的作用.方法选择因急性心肌梗死住院并行介入治疗的患者25例,按照随机分组的原则分为干细胞移植治疗组和对照组,治疗组患者在心肌梗死发生14 d后进行冠状动脉内注射自体骨髓干细胞治疗.术前1周和术后6个月时,采用99mTC-MIBI心肌灌注显像、二维超声心动图评价患者心肌灌注(SPECT积分)、左室射血分数(EF%),术后第3、7、14、28、56天时酶联免疫吸附法测定患者血清VEGF(pg/ml)浓度.结果干细胞移植治疗组与对照组比较,自体骨髓干细胞移植前两组间心肌灌注及左室射血分数比较差异无统计学意义(P>0 05).术后6个月时心肌灌注及左室射血分数治疗组明显好于对照组(P<0.05).血清VEGF浓度在细胞移植后3、56 d时移植治疗组与对照组比较差异无统计学意义(P>0.05);血清VEGF浓度在细胞移植后7、14、28 d时细胞移植治疗组明显高于对照组(P<0.05).结论急性心肌梗死后通过自体骨髓干细胞冠状动脉内移植增加患者血清VEGF浓度,改善心肌灌注,提高患者的心功能,减少心力衰竭的发生.
목적 탐토급성심기경사환자자체골수간세포관상동맥내주사개선심공능적치료중혈관내피세포생장인자(VEGF)적작용.방법 선택인급성심기경사주원병행개입치료적환자25례,안조수궤분조적원칙분위간세포이식치료조화대조조,치료조환자재심기경사발생14 d후진행관상동맥내주사자체골수간세포치료.술전1주화술후6개월시,채용99mTC-MIBI심기관주현상、이유초성심동도평개환자심기관주(SPECT적분)、좌실사혈분수(EF%),술후제3、7、14、28、56천시매련면역흡부법측정환자혈청VEGF(pg/ml)농도.결과 간세포이식치료조여대조조비교,자체골수간세포이식전량조간심기관주급좌실사혈분수비교차이무통계학의의(P>0 05).술후6개월시심기관주급좌실사혈분수치료조명현호우대조조(P<0.05).혈청VEGF농도재세포이식후3、56 d시이식치료조여대조조비교차이무통계학의의(P>0.05);혈청VEGF농도재세포이식후7、14、28 d시세포이식치료조명현고우대조조(P<0.05).결론 급성심기경사후통과자체골수간세포관상동맥내이식증가환자혈청VEGF농도,개선심기관주,제고환자적심공능,감소심력쇠갈적발생.
Objective To investigate the effect of vascular endothelial growth factor (VEGF) on left ventricular function of intracoronary transplantation of autologous bone marrow mesenchymal stem cell in patients with acute myocardial infarction. Methods After successful percutaneous coronary intervention (PCI) for acute myocardial infarction, 25 patients were randomly assigned to either a bone-marrow-cell transplantation group that received optimum medical treatment and intracoronary transfer of autologous bone-marrow cells 14 days after PCI, or a control group that received optimum postinfarction medical treatment. Datas of myocardial perfusion imaging and left ventricular ejection fraction (LVEF) were obtained by SPECT and echocardiogram respectively before and at 6 months' followed-up. The serum levels of VEGF were measured by ELISA at 3-day, 7-day, 14-day, 28-day, 56-day time-points after transplantation, respectively. Results There was no significant difference between the two groups in myocardial perfusion imaging or LVEF before intracoronary transplantation of autologous bone marrow stem cell (P>0.05). After 6 months, myocardial perfusion imaging and LVEF in treated patients was improved significantly (P<0.05) compared with the control group. There was no significant difference between the two groups of the serum levels of VEGF at 3-day, 56-day point (P>0.05). The serum levels of VEGF at 7-day, 14-day, 28-day after stem cell transplantation in patients accepted treatment were significantly higher than the levels in control patients(P<0.05). Conclusions After intracoronary transplantation of autologous bone marrow stem cell in patients with acute myocardial infarction, the left ventricular function and myocardial infusion could be improved and the heart failure decreased by the way to increase serum level of VEGF.