Huang Rong-chong, Yao Kang, Li Yan-lin, Zhang Yi-qi, Xu Shi-kun, Shi Hong-yu, Pan Cui-zhen, Yang Shan, Zhang Shao-heng, Ge Lei, Niu Yu-hong, Zhang Feng, Qian Ju-ying, Zou Yun-zeng, Ge Jun-Bo
Centre of Stem Cell and Histological Project, Shanghai Institute of Cardiovascular Disease, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2006 Feb;34(2):111-3.
The aim of this study is to identify short-term result of cell transplantation in idiopathic dilated cardiomyopathy (IDC) patients who were treated by intracoronary transplantation of autologous mononuclear bone marrow cells (BMCs) in addition to standard therapy.
Based on given standard therapy, eighteen patients with idiopathic dilated cardiomyopathy were enrolled and divided into transplantation group and control group. The clinical characteristics of two groups were comparable. Among these patients, 10 patients were performed percutaneous coronary autologous BMCs transplantation. Blood routine test, hepatic function, renal function, glucose, triglyceride (TG), cholesterol, low density cholesterol (LDL), high density cholesterol (HDL), uric acid (UA) and high sensitive C-reactive protein (hsCRP) were measured at the time point of pre-operation and some time after transplantation. All patients were monitored under ultrasonic cardiography, Holter, six-minute-walk test and magnetic resonance imaging over a period of at least 6 months. Annual hospital days were recorded during two-year follow-up.
Blood routine test, hepatic function, renal function, glucose, TG, cholesterol, LDL, HDL, UA and hsCRP had no significant differences among 48 hours, 3 months and 6 months after transplantation compared with control and pre-transplantation (P > 0.05). Six-minute-walk distance elevated significantly six months after BMCs transplantation compared with control and pre-transplantation [(494.3 +/- 62.8) m vs (307.2 +/- 75.0) m, (321.5 +/- 63.7) m, P < 0.05]. Left ventricular ejection fraction (LVEF) and the sizes of LVEDd had no significant changes compared with that of control and pre-transplantation (P > 0.05). Myocardium lesion area measured by (MRI) seemed decrease in transplantation group compared with that of control and pre-operation [(4.96 +/- 0.47) cm(2) vs (5.12 +/- 0.54) cm(2), (5.02 +/- 0.39) cm(2), P > 0.05], but there was no significance. None of proarrhythmias and side effects had been observed around transplantation and 2 years follow-up. There was no significant difference in survival between two groups in 2 years follow-up. Interestingly, annual hospital day in BMCs transplantation patients was significantly shorter than that in control group [(30.2 +/- 11.2) d vs (43.6 +/- 9.8) d, P < 0.05].
Autologous bone marrow mononuclear cells transplantation can prolong six-minute-walk, decrease re-hospitalization rate, elevate exercise ability and help to improve cardiac function in patients with IDC. In addition, it was demonstrated that cell transplantation is safe.
本研究旨在确定在接受标准治疗的基础上，通过冠状动脉内移植自体单核骨髓细胞（BMCs）治疗的特发性扩张型心肌病（IDC）患者的短期疗效。
在标准治疗的基础上，纳入18例特发性扩张型心肌病患者，分为移植组和对照组。两组的临床特征具有可比性。其中10例患者接受了经皮冠状动脉自体BMCs移植。在术前及移植后一段时间检测血常规、肝功能、肾功能、血糖、甘油三酯（TG）、胆固醇、低密度胆固醇（LDL）、高密度胆固醇（HDL）、尿酸（UA）和高敏C反应蛋白（hsCRP）。所有患者至少随访6个月，期间接受超声心动图、动态心电图、6分钟步行试验和磁共振成像监测。在两年随访期间记录年度住院天数。
与对照组和移植前相比，移植后48小时、3个月和6个月时，血常规、肝功能、肾功能、血糖、TG、胆固醇、LDL、HDL、UA和hsCRP均无显著差异（P>0.05）。与对照组和移植前相比，BMCs移植后6个月时6分钟步行距离显著增加[（494.3±62.8）m对（307.2±75.0）m，（321.5±63.7）m，P<0.05]。与对照组和移植前相比，左心室射血分数（LVEF）和左心室舒张末期内径（LVEDd）大小无显著变化（P>0.05）。与对照组和术前相比，移植组通过磁共振成像（MRI）测量的心肌病变面积似乎有所减小[（4.96±0.47）cm²对（5.12±0.54）cm²，（5.02±0.39）cm²，P > 0.05]，但无统计学意义。在移植及2年随访期间均未观察到心律失常和副作用。两组在2年随访中的生存率无显著差异。有趣的是，BMCs移植患者的年度住院天数明显短于对照组[（30.2±11.2）天对（43.6±9.8）天，P<0.05]。
自体骨髓单个核细胞移植可延长6分钟步行距离，降低再住院率，提高运动能力，并有助于改善IDC患者的心功能。此外，证明细胞移植是安全的。
