CAJ | 학술논문

目的：探讨急性心肌梗死患者（AMI）采用经冠状动脉自体骨髓单个核细胞（BM - MNCs）移植治疗的长期疗效。方法52例首次 ST 段抬高性 AMI 患者，在成功完成 PCI 术后，采用随机数字表法分为研究组和对照组各26例。研究组采用经冠状动脉注入 BM - MNCs 治疗，对照组同样方法注入等量生理盐水，比较两组患者治疗前与治疗后不同时间的随访观察结果差异。结果术前研究组和对照组的左室射血分数（LVEF%）、左室舒张末期容积（LVEDV）、心肌缺血面积、心排指数（CI）、每博量指数（SI）、二尖瓣口舒张早期峰值流速（E）/二尖瓣口舒张晚期峰值流速（A）（E/A）测定值差异无统计学意义（ P ﹥0.05）；术后6个月、24个月研究组的 LVEF%、LVEDV、心肌缺血面积、CI、SI、E/ A 测定值均显著优于对照组（ P ﹤0.05）；手术后第6个月、24个月研究组和对照组的 LVEF%、LVEDV、心肌缺血面积、CI、SI、E/ A 测定值较术前均显著好转（ P ﹤0.05）。研究组随访时间为16~24个月，平均随访时间为21.3±2.6个月，对照组随访时间15~24个月，平均随访时间20.9±3.0个月，两组患者的随访时间差异无具有统计学意义（ P ﹥0.05）。随访过程中，研究组心血管事件发生率为11.54%（3/26）显著低于对照组的34.62%（9/26）（ P ﹤0.05）。在随访过程中研究组有1例患者死亡，对照组3例患者死亡，两组患者的病死率比较差异无统计学意义（ P ﹥0.05）。结论采用经冠状动脉自体骨髓单个核细胞移植治疗对于保护 AMI 患者的心功能、降低患术后心血管事件的发生率具有积极意义。
목적：탐토급성심기경사환자（AMI）채용경관상동맥자체골수단개핵세포（BM - MNCs）이식치료적장기료효。방법52례수차 ST 단태고성 AMI 환자，재성공완성 PCI 술후，채용수궤수자표법분위연구조화대조조각26례。연구조채용경관상동맥주입 BM - MNCs 치료，대조조동양방법주입등량생리염수，비교량조환자치료전여치료후불동시간적수방관찰결과차이。결과술전연구조화대조조적좌실사혈분수（LVEF%）、좌실서장말기용적（LVEDV）、심기결혈면적、심배지수（CI）、매박량지수（SI）、이첨판구서장조기봉치류속（E）/이첨판구서장만기봉치류속（A）（E/A）측정치차이무통계학의의（ P ﹥0.05）；술후6개월、24개월연구조적 LVEF%、LVEDV、심기결혈면적、CI、SI、E/ A 측정치균현저우우대조조（ P ﹤0.05）；수술후제6개월、24개월연구조화대조조적 LVEF%、LVEDV、심기결혈면적、CI、SI、E/ A 측정치교술전균현저호전（ P ﹤0.05）。연구조수방시간위16~24개월，평균수방시간위21.3±2.6개월，대조조수방시간15~24개월，평균수방시간20.9±3.0개월，량조환자적수방시간차이무구유통계학의의（ P ﹥0.05）。수방과정중，연구조심혈관사건발생솔위11.54%（3/26）현저저우대조조적34.62%（9/26）（ P ﹤0.05）。재수방과정중연구조유1례환자사망，대조조3례환자사망，량조환자적병사솔비교차이무통계학의의（ P ﹥0.05）。결론채용경관상동맥자체골수단개핵세포이식치료대우보호 AMI 환자적심공능、강저환술후심혈관사건적발생솔구유적겁의의。
Objective To investigate the long - term effect of the treatment of acute myocardial infarction(AMI)with autologous bone marrow mononuclear cells(BM - MNCs)transplantation. Methods 52 cases of first ST segment elevation AMI patients were included into this study. All patients completed successfully PCI. All patients were divided into study group and control group using random number table,each group had 26 cases. Patient of the study received intracoronary injection in the treatment of BM MNCs,while injection with physiological saline in control group in the same way. The relative indexes of before treatment and after treatment at different time of follow - up observation results differ-ences were compared between the two groups of patients. Results The LVEF% ,LVEDV,myocardial ischemia area,CI,Si,E / A determination value difference of preoperative study group and the control group does not have statistical significance( P ﹥ 0. 05). After 6 months,24 months, LVEF% ,LVEDV,myocardial ischemia area,CI,Si,E / A determination values of study group were significantly superior to those of frontal con-trols( P ﹤ 0. 05). Surgery after 6 months and 24 months study group and LVEF% in the control group,LVEDV,myocardial ischemia area,CI, Si,E / a determination value were significantly improved compared with the preoperative( P ﹤ 0. 05). Study patients were followed up for 16 to 24 months,mean follow - up time for 21. 3 ± 2. 6 months. Patients were followed up for 15 to 24 months,mean follow - up time for 20. 9 ± 3 months control. The follow - up time difference between the two groups of patients do not show statistical significance( P ﹥ 0. 05). During the follow -up,the incidence of cardiovascular events in the study group was 11. 54%(3 / 26)was significantly lower than that in the control group(34. 62% )(9 / 26)( P ﹤ 0. 05). In the study group,1 patients died in the follow - up,3 patients died in the control group,the difference was not sta-tistically significant( P ﹥ 0. 05)in the two groups. Conclusion AMI patients were treated by intracoronary autologous bone marrow mononuclear cells transplantation in the treatment of cardiovascular events in patients with postoperative incidence is of positive significance for the protection of heart function.