中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2013年
32期
5889-5894
,共6页
干细胞%干细胞学术探讨%干细胞移植%缺血性心脏病%心肌梗死%安全性%左室射血分数%血管新生%心室重构%心功能
榦細胞%榦細胞學術探討%榦細胞移植%缺血性心髒病%心肌梗死%安全性%左室射血分數%血管新生%心室重構%心功能
간세포%간세포학술탐토%간세포이식%결혈성심장병%심기경사%안전성%좌실사혈분수%혈관신생%심실중구%심공능
stem cel s%stem cel academic discussion%stem cel transplantation%ischemic heart disease%myocardial infarction%safety%left ventricular ejection fraction%angiogenesis%ventricular remodeling%cardiac function
背景：干细胞移植到受损的心脏组织，可以大量分化为心肌细胞，这项研究为缺血性心脏病治疗带来新的希望。目的：探讨干细胞移植治疗缺血性心脏病的可行性与安全性。方法：分析干细胞移植治疗缺血性心脏病安全性和可行性的多种试验方法。REPAIR-AMI 试验是一项分析急性心肌梗死后即刻冠脉内移植骨髓祖细胞治疗效果的随机双盲、安慰剂对照的多中心研究；MAGIC Cel-3-DES试验是评价粒细胞集落刺激因子动员的干细胞疗法的安全性和冠脉内注射动员的外周血干细胞对急性心肌梗死和陈旧性心肌梗死的效果；BOOST 试验是心肌梗死后经冠脉移植自体骨髓细胞的随机对照研究。PROTECT-CAD试验是一项随机、对照的直接将干细胞注入心肌治疗慢性缺血性心肌病的临床试验。结果与结论：干细胞移植可以改善左心室的收缩功能和舒张功能以及冠脉血流储备，相关研究也得到验证。对于干细胞移植治疗缺血性心脏病，可以增加左室射血分数，临床事件较少，在药物洗脱支架治疗的基础上，干细胞治疗并不增加再狭窄风险。干细胞移植治疗缺血性心脏病安全可行，未来还需要进行大样本、长时间的大规模多中心的随机对照研究，来进一步评价其疗效和风险。
揹景：榦細胞移植到受損的心髒組織，可以大量分化為心肌細胞，這項研究為缺血性心髒病治療帶來新的希望。目的：探討榦細胞移植治療缺血性心髒病的可行性與安全性。方法：分析榦細胞移植治療缺血性心髒病安全性和可行性的多種試驗方法。REPAIR-AMI 試驗是一項分析急性心肌梗死後即刻冠脈內移植骨髓祖細胞治療效果的隨機雙盲、安慰劑對照的多中心研究；MAGIC Cel-3-DES試驗是評價粒細胞集落刺激因子動員的榦細胞療法的安全性和冠脈內註射動員的外週血榦細胞對急性心肌梗死和陳舊性心肌梗死的效果；BOOST 試驗是心肌梗死後經冠脈移植自體骨髓細胞的隨機對照研究。PROTECT-CAD試驗是一項隨機、對照的直接將榦細胞註入心肌治療慢性缺血性心肌病的臨床試驗。結果與結論：榦細胞移植可以改善左心室的收縮功能和舒張功能以及冠脈血流儲備，相關研究也得到驗證。對于榦細胞移植治療缺血性心髒病，可以增加左室射血分數，臨床事件較少，在藥物洗脫支架治療的基礎上，榦細胞治療併不增加再狹窄風險。榦細胞移植治療缺血性心髒病安全可行，未來還需要進行大樣本、長時間的大規模多中心的隨機對照研究，來進一步評價其療效和風險。
배경：간세포이식도수손적심장조직，가이대량분화위심기세포，저항연구위결혈성심장병치료대래신적희망。목적：탐토간세포이식치료결혈성심장병적가행성여안전성。방법：분석간세포이식치료결혈성심장병안전성화가행성적다충시험방법。REPAIR-AMI 시험시일항분석급성심기경사후즉각관맥내이식골수조세포치료효과적수궤쌍맹、안위제대조적다중심연구；MAGIC Cel-3-DES시험시평개립세포집락자격인자동원적간세포요법적안전성화관맥내주사동원적외주혈간세포대급성심기경사화진구성심기경사적효과；BOOST 시험시심기경사후경관맥이식자체골수세포적수궤대조연구。PROTECT-CAD시험시일항수궤、대조적직접장간세포주입심기치료만성결혈성심기병적림상시험。결과여결론：간세포이식가이개선좌심실적수축공능화서장공능이급관맥혈류저비，상관연구야득도험증。대우간세포이식치료결혈성심장병，가이증가좌실사혈분수，림상사건교소，재약물세탈지가치료적기출상，간세포치료병불증가재협착풍험。간세포이식치료결혈성심장병안전가행，미래환수요진행대양본、장시간적대규모다중심적수궤대조연구，래진일보평개기료효화풍험。
BACKGROUND:The stem cel s transplanted into the damaged heart tissues can differentiate into cardiomyocytes, which bring new hope for the research of ischemic heart disease. OBJECTIVE:To explore the feasibility and safety of stem cel transplantation for the treatment of ischemic heart disease. METHODS:Various experimental methods to the feasibility and safety of stem cel transplantation for the treatment of ischemic heart disease were analyzed. REPAIR-AMI experiment was a randomized and double-blind and placebo-control ed multi-center study that used to analyze the therapeutic effect of intracoronary transplantation of bone marrow progenitor cel s immediately after acute myocardial infarction. MAGIC Cel-3-DES experiment was used to evaluate the safety of granulocyte colony-stimulating factor mobilized stem cel therapy and the effect of intracoronary injection of mobilized peripheral blood stem cel s on the treatment of acute myocardial infarction and old myocardial infarction. BOOST experiment was the randomized control ed study on autologous bone marrow cel transplantation through coronary vein after myocardial infarction. PROTECT-CAD experiment was the randomized control ed clinical trial about the direct injection of stem cel s into the myocardial for the treatment of ischemic heart disease. RESUTLS AND CONCLUSION:Stem cel transplantation may improve the left ventricular systolic function and left ventricular diastolic function as wel as the coronary flow reserve, and the related studies have been confirmed. Stem cel transplantation for the treatment of ischemic heart disease can increase the left ventricular ejection fraction. As the less clinical accident, stem cel therapy cannot increase the risk of restenosis based on the treatment of drug-eluting stents. It is safe and feasible of stem cel transplantation for the treatment of ischemic heart disease. Large sample, long scale and multi-center randomized control ed studies are needed to further evaluate the effect and risk of stem cel transplantation.
