[粒细胞集落刺激因子动员的自体外周血干细胞冠状动脉内移植治疗急性心肌梗死患者的安全性和有效性]

[Safety and efficacy of intracoronary transplantation of G-CSF mobilized autologous peripheral blood stem cells in patients with acute myocardial infarction].

作者信息

Li Zhan-quan, Zhang Ming, Jin Yuan-zhe, Zhang Wei-wei, Liu Ying, Yuan Long, Cui Li-Jie, Liu Xian-zhi, Yu Xian, Hu Tie-shi

机构信息

Liaoning Provincial People's Hospital, Liaoning Provincial Cardiovascular Hospital, Shenyang 110016, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2006 Feb;34(2):99-102.

PMID:16626571

Abstract

OBJECTIVE

To investigate the safety and efficacy of intracoronary transplantation of G-CSF mobilized autologous peripheral blood stem cells in patients with acute myocardial infarction (AMI).

METHODS

Patients with AMI were randomly assigned to receive intracoronary PBSCs transplantation following bone marrow cells mobilization by granulocyte colony-stimulating factor (300-600 microg/day subcutaneously for 5 days) in addition to standard therapy (standard drug therapy and PCI, PBSCs transplantation group, n = 35) or standard therapy (standard drug therapy and PCI, n = 35). One day after G-CSF treatment was finished the patient's mononuclear cells were harvested by Baxter CS 3000 blood cell separator in a volume of 57 ml and then transferred into the infarct related artery by occluding the over the wire balloon and infusing artery through balloon center lumen. Complications during intervention and left ventricular function at baseline and 6 months thereafter were monitored.

RESULTS

No severe side effects of G-CSF treatment could be observed. Malignant arrhythmias were not observed either. Left ventricular function was significantly improved 6 months after G-CSF mobilized autologous peripheral blood stem cell transplantation compared to baseline (global left ventricular function ejection fraction: 57.1 +/- 7.8 vs. 50.0 +/- 8.2%, P < 0.0001; WMSI: 1.101 +/- 0.118 vs. 1.219 +/- 0.190, P < 0.0001; left end-systolic volume: 52.6 +/- 20.3 vs. 63.8 +/- 23.9 ml, P = 0.01 and left end-diastolic volume: 119.2 +/- 30.3 vs. 134.2 +/- 36.7 ml, P = 0.07) while these parameters remained unchanged in the control group.

CONCLUSION

The present study demonstrates that G-CSF mobilized autologous intracoronary PBSCs transplantation is a safe and feasible treatment for patients with AMI and global left ventricular function is improved and left ventricular remodeling attenuated at six-month follow-up.

摘要

目的

探讨粒细胞集落刺激因子（G-CSF）动员的自体外周血干细胞冠状动脉内移植治疗急性心肌梗死（AMI）患者的安全性和有效性。

方法

将AMI患者随机分为两组，一组在标准治疗（标准药物治疗和经皮冠状动脉介入治疗，PCI）基础上，接受粒细胞集落刺激因子动员骨髓细胞后（皮下注射300 - 600微克/天，共5天）的冠状动脉内外周血干细胞移植（外周血干细胞移植组，n = 35）；另一组仅接受标准治疗（标准药物治疗和PCI，n = 35）。G-CSF治疗结束后1天，用百特CS 3000血细胞分离机采集患者57毫升单核细胞，然后通过阻断导丝球囊并经球囊中心腔向梗死相关动脉内注入。监测干预过程中的并发症以及基线时和此后6个月的左心室功能。

结果

未观察到G-CSF治疗的严重副作用，也未观察到恶性心律失常。与基线相比，G-CSF动员的自体外周血干细胞移植6个月后左心室功能显著改善（左心室整体功能射血分数：57.1±7.8% 对50.0±8.2%，P < 0.0001；室壁运动记分指数：1.101±0.118对1.219±0.190，P < 0.0001；左心室收缩末期容积：52.6±20.3毫升对63.8±23.9毫升，P = 0.01；左心室舒张末期容积：119.2±30.3毫升对134.2±36.7毫升，P = 0.07），而对照组这些参数保持不变。