Nie Ying, Guo Yan Hong, Guo Li Jun
Department of Cardiology, Peking University Third Hospital and Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing 100083, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2007 Dec 18;39(6):634-7.
To evaluate the efficacy of intracoronary transfer of autologous bone marrow mononuclear stem cells in patients with heart dysfunction after myocardial infarction.
Forty-two patients with anterior myocardial infarction [BMSC(bone marrow mononuclear stem cells) group: 13 cases; control group: 29 cases] were treated by standard percutaneous coronary intervention (PCI) and medical therapy. Patients in BMSC group were also transplanted bone marrow mononuclear stem cells through coronary injection. Baseline and 12 months' follow-up evaluations included New York Heart Association Class ( NYHA class) and the level of plasma NT-proBNP, six minutes walk test, single photon emission computed tomography(SPECT).
In BMSC group, the NYHA class improved significantly at the end of the 12 months' follow-up (1.54+/-0.27 vs. 2.62+/-0.33, P=0.002) and was better than that of control group (2.45+/-0.21, P=0.02). The level of plasma NTjproBNP reduced significantly [(701.05+/-154.60) ng/L vs. (1,921.70+/-373.70) ng/L, P=0.000 8]. The distances of six minutes walk test of the two groups increased significantly [BMSC group: (432.85+/-27.81) m vs. (363.77+/-20.14) m, P=0.000 6;control group: (381.48+/-17.72) m vs. (339.00+/-9.87) m, P=0.000 5], but the difference was not obvious between the two groups. The score of myocardial blood perfusion improved significantly in BMSC group at the end of the 12 months' follow-up (31.15+/-3.65 vs. 46.31+/-2.87, P=0.002) and was better than that of control group (42.59+/-2.08,P=0.015 7). The area of the perfusion defects in SPECT reduced significantly in BMSC group [(32.23+/-4.40)% vs. (39.54+/-3.76)%, P=0.000 1], but no obvious difference was found between the two groups. Global LVEF of BMSC group increased [(38.54+/-2.94)% vs. (35.38+/-2.16)%, P>0.05).
Intracoronary transplantation of bone marrow mononuclear cells could improve myocardial blood perfusion and increase the systolic function in patients with heart failure after myocardial infarction.
评估自体骨髓单个核干细胞冠状动脉内移植对心肌梗死后心功能不全患者的疗效。
42例前壁心肌梗死患者[骨髓单个核干细胞组(BMSC组):13例;对照组:29例]接受标准经皮冠状动脉介入治疗(PCI)及药物治疗。BMSC组患者还通过冠状动脉注射移植了骨髓单个核干细胞。基线及12个月随访评估包括纽约心脏协会心功能分级(NYHA分级)、血浆N末端脑钠肽前体(NT-proBNP)水平、6分钟步行试验、单光子发射计算机断层扫描(SPECT)。
BMSC组在12个月随访结束时NYHA分级显著改善(1.54±0.27比2.62±0.33,P=0.002),且优于对照组(2.45±0.21,P=0.02)。血浆NT-proBNP水平显著降低[(701.05±154.60)ng/L比(1921.70±373.70)ng/L,P=0.000 8]。两组6分钟步行试验距离均显著增加[BMSC组:(432.85±27.81)m比(363.77±20.14)m,P=0.000 6;对照组:(381.48±17.72)m比(339.00±9.87)m,P=0.000 5],但两组间差异不明显。BMSC组在12个月随访结束时心肌血流灌注评分显著改善(31.15±3.65比46.31±2.87,P=0.002),且优于对照组(42.59±2.08,P=0.015 7)。BMSC组SPECT灌注缺损面积显著减小[(32.23±4.40)%比(39.54±3.76)%,P=0.000 1],但两组间无明显差异。BMSC组整体左心室射血分数(LVEF)增加[(38.54±2.94)%比(35.38±2.16)%,P>0.05]。
冠状动脉内移植骨髓单个核细胞可改善心肌梗死后心力衰竭患者的心肌血流灌注并增加收缩功能。