CAJ | 학술논문

目的：探究骨髓干细胞动员结合冠状动脉介入（PCI）治疗对慢性缺血性心脏病患者心功能的影响及其安全性。方法收集41例合并有粒细胞减少的慢性缺血性心脏病患者。随机将患者分入对照组和粒细胞集落刺激因子（G- CSF）组。在规范药物治疗和成功进行PCI治疗基础上，G- CSF组接受G- CSF皮下注射。住院及随访期间进行血液学检查、超声心动图检查并进行6min步行试验。结果治疗前两组基线资料、冠状动脉造影以及PCI相关参数差异均无统计学意义（均P＞0.05）。在6个月随访时，两组患者缺血节段室壁增厚率、LVEF均较治疗前增加，而Tei指数较治疗前降低（均P＜0.05）；两组室壁运动评分指数均在随访时得到改善，但与治疗前比较差异无统计学意义，随访变化值差异亦无统计学意义（均P＞0.05）。6个月随访时两组LVEDV、Tei指数差异有统计学意义，随访变化值差异亦有统计学意义（均P＜0.05）。两组患者6min步行距离的随访变化值无统计学意义(P＞0.05)。住院及随访期间两组患者均未出现严重不良心脏事件。结论对慢性缺血性心脏病患者在成功地进行PCI治疗后利用G- CSF进行干细胞动员是安全的，对心功能的改善有一定的积极作用。
목적：탐구골수간세포동원결합관상동맥개입（PCI）치료대만성결혈성심장병환자심공능적영향급기안전성。방법수집41례합병유립세포감소적만성결혈성심장병환자。수궤장환자분입대조조화립세포집락자격인자（G- CSF）조。재규범약물치료화성공진행PCI치료기출상，G- CSF조접수G- CSF피하주사。주원급수방기간진행혈액학검사、초성심동도검사병진행6min보행시험。결과치료전량조기선자료、관상동맥조영이급PCI상관삼수차이균무통계학의의（균P＞0.05）。재6개월수방시，량조환자결혈절단실벽증후솔、LVEF균교치료전증가，이Tei지수교치료전강저（균P＜0.05）；량조실벽운동평분지수균재수방시득도개선，단여치료전비교차이무통계학의의，수방변화치차이역무통계학의의（균P＞0.05）。6개월수방시량조LVEDV、Tei지수차이유통계학의의，수방변화치차이역유통계학의의（균P＜0.05）。량조환자6min보행거리적수방변화치무통계학의의(P＞0.05)。주원급수방기간량조환자균미출현엄중불양심장사건。결론대만성결혈성심장병환자재성공지진행PCI치료후이용G- CSF진행간세포동원시안전적，대심공능적개선유일정적적겁작용。
Objective To evaluate the efficacy of bone marrow stem cellmobilization by G- CSF in patients with chronic ischemic heart disease (CIHD) after revascularization. Methods Forty one patients with CIHD and granulopenia who had suc-cessful fractional Percutaneous coronary intervention (PCI) were included in the study. Patients were randomized into G- CSF group (G- CSF10μg/kg for 7d) and control group (no G- CSF was given). Patients were fol owed up for 6 months. Results De-mographics, clinical characteristics, and parameter of CAG and PCI were homogeneous between two groups (P>0.05). The wal thickening in severe impaired segment, LVEF, and Tei index in both group were significantly improved 6 months after treatment (P<0.05);while there were no significant differences in MWSI and LVEDV of both groups before and after treatment (P>0.05). There were significant differences in changes of LVEDV and Tei index between two groups (P<0.05), but the changes of distance in 6 min walk test before and after treatment showed no difference between two groups (P>0.05). No severe adverse events oc-curred in both groups in 6- month fol ow up. Conclusion Mobilization of bone marrow stem cells by G- CSF seems to be benefi-cial for cardiac function in patients with CIHD after successful fractional PCI.