CAJ | 학술논문

干细胞%干细胞移植%骨髓单个核细胞%经冠状动脉注射%心功能%毛细血管密度%基质金质层白酶%细胞因子%省级基金%干细胞图片文章榦細胞%榦細胞移植%骨髓單箇覈細胞%經冠狀動脈註射%心功能%毛細血管密度%基質金質層白酶%細胞因子%省級基金%榦細胞圖片文章
간세포%간세포이식%골수단개핵세포%경관상동맥주사%심공능%모세혈관밀도%기질금질층백매%세포인자%성급기금%간세포도편문장
stem cel s%stem cel transplantation%bone marrow mononuclear cel%intracoronary infusion%cardiac function%capil ary density%matrix metal oproteinase-9%cytokine%provincial grants-supported paper%stem cel photographs-containing paper

　　背景：干细胞移植为治疗心肌梗死带来新的希望，但研究结果不一致，存在争议。细胞移植能否长期持久地改善心脏功能、改善缺血心功能的机制这些问题均不明确。目的：观察经冠状动脉自体骨髓单个核细胞移植对急性心肌梗死犬心功能、血管生成和细胞因子分泌的影响。方法：杂种犬分为骨髓单个核细胞组(n=10)和生理盐水组(n=6)，前上嵴或髂后上棘穿刺分离得到骨髓单个核细胞，结扎冠状动脉前降支建立急性心肌梗死模型，于心肌梗死后2h分别经冠状动脉内移植骨髓单个核细胞和生理盐水，心肌梗死后2 h及6周时分别测定超声心动图指标，骨髓单个核细胞移植后6周vWF免疫组化染色检测心肌组织的毛细血管密度，RT-PCR检测血管内皮生长因子(血管内皮生长因子188、血管内皮生长因子164)、碱性成纤维细胞生长因子、基质金属蛋白酶9 mRNA的表达。结果与结论：经冠状动脉自体骨髓单个核细胞移植后6周，超声心动图显示，骨髓单个核细胞组射血分数和每搏输出量比生理盐水组显著升高；梗死边缘区新生血管数量明显高于生理盐水组。骨髓单个核细胞组梗死区血管内皮生长因子188、血管内皮生长因子164和碱性成纤维细胞生长因子mRNA表达水平显著高于生理盐水组。骨髓单个核细胞组梗死区基质金属蛋白酶9 mRNA 表达水平显著低于生理盐水组。结果说明自体骨髓单个核细胞经冠状动脉内注射移植，改善急性心肌梗死后心功能，促进梗死边缘区血管生成，提高促血管生长因子血管内皮生长因子188、血管内皮生长因子164和碱性成纤维细胞生长因子的mRNA表达水平，减少基质金属蛋白酶9 mRNA表达水平。
　　배경：간세포이식위치료심기경사대래신적희망，단연구결과불일치，존재쟁의。세포이식능부장기지구지개선심장공능、개선결혈심공능적궤제저사문제균불명학。목적：관찰경관상동맥자체골수단개핵세포이식대급성심기경사견심공능、혈관생성화세포인자분비적영향。방법：잡충견분위골수단개핵세포조(n=10)화생리염수조(n=6)，전상척혹가후상극천자분리득도골수단개핵세포，결찰관상동맥전강지건립급성심기경사모형，우심기경사후2h분별경관상동맥내이식골수단개핵세포화생리염수，심기경사후2 h급6주시분별측정초성심동도지표，골수단개핵세포이식후6주vWF면역조화염색검측심기조직적모세혈관밀도，RT-PCR검측혈관내피생장인자(혈관내피생장인자188、혈관내피생장인자164)、감성성섬유세포생장인자、기질금속단백매9 mRNA적표체。결과여결론：경관상동맥자체골수단개핵세포이식후6주，초성심동도현시，골수단개핵세포조사혈분수화매박수출량비생리염수조현저승고；경사변연구신생혈관수량명현고우생리염수조。골수단개핵세포조경사구혈관내피생장인자188、혈관내피생장인자164화감성성섬유세포생장인자mRNA표체수평현저고우생리염수조。골수단개핵세포조경사구기질금속단백매9 mRNA 표체수평현저저우생리염수조。결과설명자체골수단개핵세포경관상동맥내주사이식，개선급성심기경사후심공능，촉진경사변연구혈관생성，제고촉혈관생장인자혈관내피생장인자188、혈관내피생장인자164화감성성섬유세포생장인자적mRNA표체수평，감소기질금속단백매9 mRNA표체수평。
BACKGROUND:Cel transplantation offers a new promise of rebuilding the damaged myocardium. But the results of them are not consistent. It is not clear if the transplanted cel s can permanently improve heart function and the mechanism underlying this therapeutic effect. OBJECTIVE:To study the effect of intracoronary autologous bone marrow mononuclear cel transplantation on cardiac function, and angiogenesis and cytokine production in canines with acute myocardial infarction. METHODS:Left anterior descending coronary artery ligation was used to produce acute myocardial infarction models in hybrid canines. Bone marrow mononuclear cel s were harvested by using puncture of anterior crest and posterior superior iliac spine to prepare cel suspension. Sixteen hybrid canines were randomly divided into transplantation group (n=10) and control group (n=6). Bone marrow mononuclear cel s (transplantation group, n=10) or normal saline (control group, n=6) were intracoronarily infused into infarction-related arteries 2 hours after acute myocardial infarction. To evaluate the heart function, we used echocardiography at 2 hours and 6 weeks after acute myocardial infarction. Capil ary density was assessed 6 weeks after transplantation by using von Wil ebrand factor test. The mRNA levels of vascular endothelial growth factor 188, vascular endothelial growth factor 164, basic fibroblast growth factor and matrix metal oproteinase-9 in the infarct area were determined by reverse transcription-PCR at 6 weeks after transplantation. RESULTS AND CONCLUSION:In contrast to the control group, ejection fraction and stroke volume at 6 weeks after transplantation increased significantly in the transplantation group. The transplantation group had a greater amount of new vessels in the peri-infarct area than the control group. Compared with the control group, the mRNA levels of vascular endothelial growth factor 188, vascular endothelial growth factor 164, and basic fibroblast growth factor significantly increased in the transplantation group, but the mRNA level of matrix metal oproteinase-9 significantly decreased in the transplantation group. These findings suggest that intracoronary transplantation of autologous bone marrow mononuclear cel s may improve the cardiac function, and increase capil ary density, especial y in the border zone of infarcted myocardium. Otherwise, bone marrow mononuclear cel transplantation can increase the mRNA levels of vascular endothelial growth factor 188, vascular endothelial growth factor 164, and basic fibroblast growth factor, but decrease the mRNA level of matrix metal oproteinase-9.