CAJ | 학술논문

背景:药物、介入或外科治疗均不能从根本上解决心脏缺血梗死后心肌细胞丧失问题.大量研究结果显示自体心脏干细胞移植治疗缺血性心肌病安全可行,可减少梗死瘢痕面积、改善心室重构、提高心脏功能.目前自体心脏干细胞移植治疗缺血性心肌病已进入临床试验阶段.目的:综述近年国内外自体心脏干细胞移植治疗缺血性心肌病的研究进展.方法:第一作者应用计算机检索1998年1月至2012年4月PubMed数据库、中国期刊全文数据库相关文章,英文检索词“autologous, cardiac stem cel s, ischemic cardiomyopathy, transplantation, treatment”;中文检索词“自体,心脏干细胞,缺血性心肌病,移植,治疗”.共检索到82篇相关文献,57篇文献符合纳入标准.结果与结论:经过大量小动物实验和大型动物的前临床实验准备阶段,目前自体心脏干细胞移植治疗缺血性心肌病已经进入临床试验阶段,初步临床试验结果显示自体心脏干细胞移植治疗缺血性心肌病安全、可行、有效.从心脏中分离的心脏干细胞移植到自体缺血梗死的心脏,可以分化生成心肌细胞、内皮细胞、平滑肌细胞,抑制心室重构,改善心脏收缩、舒张功能.相对于其他来源的干细胞移植治疗,自体心脏干细胞移植治疗缺血性心肌病无免疫源性,不存在免疫排斥反应;不存在伦理问题;其趋向分化成心脏细胞系,成瘤率低,相对安全.自体心脏干细胞移植为缺血性心肌病的治疗提供了一条新的途径,有更高的临床应用价值.但目前开展的临床试验较少,观测时间不够长,缺少多中心大样本量的临床试验等,这些都需要进一步研究探索.
배경:약물、개입혹외과치료균불능종근본상해결심장결혈경사후심기세포상실문제.대량연구결과현시자체심장간세포이식치료결혈성심기병안전가행,가감소경사반흔면적、개선심실중구、제고심장공능.목전자체심장간세포이식치료결혈성심기병이진입림상시험계단.목적:종술근년국내외자체심장간세포이식치료결혈성심기병적연구진전.방법:제일작자응용계산궤검색1998년1월지2012년4월PubMed수거고、중국기간전문수거고상관문장,영문검색사“autologous, cardiac stem cel s, ischemic cardiomyopathy, transplantation, treatment”;중문검색사“자체,심장간세포,결혈성심기병,이식,치료”.공검색도82편상관문헌,57편문헌부합납입표준.결과여결론:경과대량소동물실험화대형동물적전림상실험준비계단,목전자체심장간세포이식치료결혈성심기병이경진입림상시험계단,초보림상시험결과현시자체심장간세포이식치료결혈성심기병안전、가행、유효.종심장중분리적심장간세포이식도자체결혈경사적심장,가이분화생성심기세포、내피세포、평활기세포,억제심실중구,개선심장수축、서장공능.상대우기타래원적간세포이식치료,자체심장간세포이식치료결혈성심기병무면역원성,불존재면역배척반응;불존재윤리문제;기추향분화성심장세포계,성류솔저,상대안전.자체심장간세포이식위결혈성심기병적치료제공료일조신적도경,유경고적림상응용개치.단목전개전적림상시험교소,관측시간불구장,결소다중심대양본량적림상시험등,저사도수요진일보연구탐색.
BACKGROUND:Drugs, interventional or surgical treatment cannot fundamental y solve the loss of myocardial cel s after ischemic infarction. Many studies have shown that autologous cardiac stem cel s transplantation for treatment of ischemic cardiomyopathy is safe and feasible, and it can produce the neonatal cardiac myocytes, reduce the size of infarct scar, inhibit the ventricular remodeling and improve cardiac function. At present, autologous cardiac stem cel s transplantation for treatment of ischemic cardiomyopathy has entered clinical trials. OBJECTIVE:To summarize the research progress of autologous cardiac stem cel s transplantation for treatment of ischemic cardiomyopathy at home and abroad in recent years. METHODS:The first author retrieved PubMed database and China Academic Journal article from January 1998 to April 2012 using computer. The key words were“autologous, cardiac stem cel s, ischemic cardiomyopathy, transplantation, treatment”. We retrieved 82 articles, and 57 articles were included in the review. RESULTS AND CONCLUSION:Transplantation of cardiac stem cel s derived from autologous heart tissue to the ischemic infarction region of the heart can differentiate and generate new cardiomyocytes as wel as endothelial cel s, inhibit ventricular remodeling, and improve cardiac regional systolic and diastolic function. Transplantation of autologous cardiac stem cel s provides a new therapeutic approach for the treatment of ischemic cardiomyopathy. Compared to other sources of stem cel s, transplantation of autologous cardiac stem cel s for treatment of ischemic cardiomyopathy has higher clinical value.