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自体骨髓细胞移植联合非体外循环冠状动脉旁路移植术对慢性心肌梗死患者心功能的影响。

Effect of autologous bone marrow cell transplantation combined with off-pump coronary artery bypass grafting on cardiac function in patients with chronic myocardial infarction.

作者信息

Wang Huishan, Wang Zengwei, Jiang Hui, Ma Dongchu, Zhou Weiwei, Zhang Guoxu, Chen Wei, Huang Jianhua, Liu Yu

机构信息

Department of Cardiac Surgery, Shenyang Northern Hospital, Shenyang, PR China.

出版信息

Cardiology. 2015;130(1):27-33. doi: 10.1159/000369381. Epub 2014 Dec 6.

Abstract

OBJECTIVES

This study aimed to investigate the feasibility and effects of intramuscular injections of autologous bone marrow cells (BMC) combined with off-pump coronary artery bypass grafts (OPCAB) on improving cardiac function in chronic myocardial infarction patients.

METHODS

Ninety patients with chronic myocardial infarction were prospectively enrolled and randomized to an OPCAB with saline or an OPCAB with BMC-treatment group. After finishing CABG, patients received injections of BMC or saline into the marginal area of the infarct. The primary endpoint was incidence of emergent adverse events within 6 months.

RESULTS

There were no differences between the control and BMC-treated groups in baseline ejection fractions (EF) or wall motion score indices (WMSI) in the affected segments. At the 6-month follow-up, the ejection fraction was significantly increased in the BMC-treated group compared to controls (47.58 ± 6.34 vs. 40.11 ± 7.42; p < 0.05), whereas the WMSI were significantly decreased (1.25 ± 0.32 vs. 1.54 ± 0.53; p < 0.05), with no occurrences of life-threatening arrhythmias or death. The addition of BMC injections to OPCAB treatment increased regional perfusion to the marginal infarct area.

CONCLUSION

These results demonstrate that BMC transplant is beneficial to the cardiac function with no adverse effects, and therefore a safe and feasible adjunct therapy providing beneficial effects in clinical practice.

摘要

目的

本研究旨在探讨肌肉注射自体骨髓细胞(BMC)联合非体外循环冠状动脉搭桥术(OPCAB)改善慢性心肌梗死患者心功能的可行性及效果。

方法

前瞻性纳入90例慢性心肌梗死患者,随机分为OPCAB联合生理盐水组或OPCAB联合BMC治疗组。冠状动脉搭桥术完成后,患者在梗死边缘区域注射BMC或生理盐水。主要终点为6个月内紧急不良事件的发生率。

结果

对照组和BMC治疗组在基线射血分数(EF)或梗死节段室壁运动评分指数(WMSI)方面无差异。在6个月随访时,与对照组相比,BMC治疗组的射血分数显著增加(47.58±6.34对40.11±7.42;p<0.05),而WMSI显著降低(1.25±0.32对1.54±0.53;p<0.05),且未发生危及生命的心律失常或死亡。在OPCAB治疗中添加BMC注射可增加梗死边缘区域的局部灌注。

结论

这些结果表明,BMC移植对心功能有益且无不良反应,因此是一种安全可行的辅助治疗方法,在临床实践中具有有益效果。

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