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经冠状动脉骨髓源性祖细胞移植治疗儿童心肌梗死:初步的儿科经验。

Transcoronary bone marrow-derived progenitor cells in a child with myocardial infarction: first pediatric experience.

机构信息

Division of Pediatric Cardiology, Department of Pediatrics, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

出版信息

Clin Cardiol. 2010 Aug;33(8):E7-12. doi: 10.1002/clc.20463.

Abstract

BACKGROUND

Recent advances in stem cell therapy to restore cardiac function have great promise for patients with congestive heart failure after myocardial infarction in an adult population.

OBJECTIVE

We examined the benefits of bone marrow-derived progenitor cells treatment modality for the pediatric patient.

METHODS AND RESULTS

We present our first case of transcoronary autologous stem cell transplantation in a 9-year-old girl with refractory congestive heart failure secondary to myocardial infarction 1 year after transcatheter revascularization. The child received daily injections of granulocyte colony-stimulating factor for 3 days prior to the bone marrow aspiration. The bone marrow cells were isolated to constitute CD133+/CD34+ more than 90% of the total number. Subsequently, the progenitor cell suspension was injected via a transcoronary catheter without any complication. Three months after stem cell therapy, her cardiac function, assessed by both cardiac magnetic resonance and echocardiogram, has been improved with the left ventricular ejection fraction at 47% compared to the baseline of 30%.

CONCLUSION

This is the first reported pediatric case of successful transcoronary injection of bone marrow-derived progenitor cells for end-stage heart disease. The procedure is considered safe and feasible for the pediatric population.

摘要

背景

最近在干细胞治疗方面的进展为心肌梗死后充血性心力衰竭的成年患者恢复心脏功能带来了巨大希望。

目的

我们研究了骨髓源性祖细胞治疗方式对儿科患者的益处。

方法和结果

我们报告了首例经冠状动脉自体干细胞移植治疗 1 年前经导管血运重建后发生心肌梗死后难治性充血性心力衰竭的 9 岁女孩。该患儿在骨髓抽吸前连续 3 天每日接受粒细胞集落刺激因子注射。将骨髓细胞分离,构成 CD133+/CD34+,占总数的 90%以上。随后,通过经冠状动脉导管注入祖细胞悬液,无任何并发症。干细胞治疗 3 个月后,通过心脏磁共振和超声心动图评估其心功能得到改善,左心室射血分数从基线的 30%提高至 47%。

结论

这是首例成功报告经冠状动脉注射骨髓源性祖细胞治疗终末期心脏病的儿科病例。该操作对于儿科人群被认为是安全且可行的。

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