目的:观察自体骨髓单个核细胞冠脉内移植治疗扩张型心肌病的临床疗效。方法:扩张型心肌病16例(男性5例, 女性11例),平均年龄(45．3±10．8)岁,心功能Ⅳ级,左室射血分数(LVEF)<30％。抽取骨髓,用Ficoll密度梯度离心法分离骨髓单...目的:观察自体骨髓单个核细胞冠脉内移植治疗扩张型心肌病的临床疗效。方法:扩张型心肌病16例(男性5例, 女性11例),平均年龄(45．3±10．8)岁,心功能Ⅳ级,左室射血分数(LVEF)<30％。抽取骨髓,用Ficoll密度梯度离心法分离骨髓单个核细胞,经外周动脉穿刺插管,将骨髓单个核细胞分别直接注入左、右冠脉。比较移植前后心功能的变化。结果:移植3个月后,心功能(NYHA分级)得到改善,总有效率87．5％,超声心动图检查均示左室舒张末径(mm)(72．94± 4．01 vs 63．63±2．58．P<0．001)、左室收缩末径(mm)(52．00±2．80 vs 44．38±1．78．P<0．001)减小,左室射血分数(％) (22．88±5．29vs33．81±3．33,P<0．001)、短轴缩短率(％)(12．00±2．39 vs 20．94±3．70,P<0．001)明显增加;心脏ECT 检查与术前相比,术后患者缺血及坏死心肌节段减少,(3．4±0．3vs2．1±0．4,P<0．05)(2．5±0．5 vs 1．6±0.3,P< 0．01)个。结论:自体骨髓单个核细胞移植有可能通过缺血心肌血运改善,坏死心肌区有心肌细胞再生而改善扩张型心肌病的心功能。展开更多
To probe into the influence of transplantation of allogenic bone marrow mononuclear cells （BM-MNCs） on the left ventricular remodeling of rat after acute myocardial infarction （AMI）, 60 male Wistar rats were evenl...To probe into the influence of transplantation of allogenic bone marrow mononuclear cells （BM-MNCs） on the left ventricular remodeling of rat after acute myocardial infarction （AMI）, 60 male Wistar rats were evenly divided into three groups at random： control group 1, control group 2 and transplantation group. In control group 1, chest was opened without ligation of coronary artery; in control group 2 and transplantation group, the left anterior descending branch of coronary artery was ligated to establish AMI model. Prepared culture medium and allogenic BM-MNCs suspension were respectively implanted the surrounding area of infracted cardiac muscle via epicardium of control group 2 and transplantation group. Four weeks after the operation, the osteopontin gene （OPN mRNA, P〈0.01）, type Ⅰ collagen （P〈0.01） and angiotensin Ⅱ （AngⅡ, P〈0.01） content in the left ventricular non-infracted myocardium, and the Ang Ⅱ density in blood plasma （P〈0.05） of transplantation group and control group 2 were all significantly higher than that of control group Ⅰ. In the transplantation group, the myocardial OPN InRNA, type Ⅰ collagen and Ang Ⅱ content of non-infracted zone in left ventricle, and the Ang Ⅱ concentration in blood plasma were all significantly lower than those of control group 2 （P〈0.05 for all）. It is concluded that allogenic BM-MNCs transplantation may ease left ventricular remodeling after AMI by inhibiting the synthesis of type Ⅰ collagen in the cardiac muscle and down-regulating the expression of Ang Ⅱ and OPN gene.展开更多
文摘目的:观察自体骨髓单个核细胞冠脉内移植治疗扩张型心肌病的临床疗效。方法:扩张型心肌病16例(男性5例, 女性11例),平均年龄(45．3±10．8)岁,心功能Ⅳ级,左室射血分数(LVEF)<30％。抽取骨髓,用Ficoll密度梯度离心法分离骨髓单个核细胞,经外周动脉穿刺插管,将骨髓单个核细胞分别直接注入左、右冠脉。比较移植前后心功能的变化。结果:移植3个月后,心功能(NYHA分级)得到改善,总有效率87．5％,超声心动图检查均示左室舒张末径(mm)(72．94± 4．01 vs 63．63±2．58．P<0．001)、左室收缩末径(mm)(52．00±2．80 vs 44．38±1．78．P<0．001)减小,左室射血分数(％) (22．88±5．29vs33．81±3．33,P<0．001)、短轴缩短率(％)(12．00±2．39 vs 20．94±3．70,P<0．001)明显增加;心脏ECT 检查与术前相比,术后患者缺血及坏死心肌节段减少,(3．4±0．3vs2．1±0．4,P<0．05)(2．5±0．5 vs 1．6±0.3,P< 0．01)个。结论:自体骨髓单个核细胞移植有可能通过缺血心肌血运改善,坏死心肌区有心肌细胞再生而改善扩张型心肌病的心功能。
文摘To probe into the influence of transplantation of allogenic bone marrow mononuclear cells （BM-MNCs） on the left ventricular remodeling of rat after acute myocardial infarction （AMI）, 60 male Wistar rats were evenly divided into three groups at random： control group 1, control group 2 and transplantation group. In control group 1, chest was opened without ligation of coronary artery; in control group 2 and transplantation group, the left anterior descending branch of coronary artery was ligated to establish AMI model. Prepared culture medium and allogenic BM-MNCs suspension were respectively implanted the surrounding area of infracted cardiac muscle via epicardium of control group 2 and transplantation group. Four weeks after the operation, the osteopontin gene （OPN mRNA, P〈0.01）, type Ⅰ collagen （P〈0.01） and angiotensin Ⅱ （AngⅡ, P〈0.01） content in the left ventricular non-infracted myocardium, and the Ang Ⅱ density in blood plasma （P〈0.05） of transplantation group and control group 2 were all significantly higher than that of control group Ⅰ. In the transplantation group, the myocardial OPN InRNA, type Ⅰ collagen and Ang Ⅱ content of non-infracted zone in left ventricle, and the Ang Ⅱ concentration in blood plasma were all significantly lower than those of control group 2 （P〈0.05 for all）. It is concluded that allogenic BM-MNCs transplantation may ease left ventricular remodeling after AMI by inhibiting the synthesis of type Ⅰ collagen in the cardiac muscle and down-regulating the expression of Ang Ⅱ and OPN gene.
文摘目的比较骨髓单个核细胞(MNCs)和骨髓源内皮祖细胞(EPCs)移植促进血流重建的效果,探讨非内皮祖细胞在血流重建中的作用。方法获取Lewis大鼠骨髓MNCs,部分MNCs在体外诱导分化为EPCs。采用Lewis大鼠建立单侧后肢缺血模型。建模后3 d,将模型鼠随机分为3组:(1)对照组(n=6),将0.8 mL D-Hank′s液注入对照组大鼠缺血侧后肢;(2)MNC组(n=6),将8×106个骨髓MNC植入MNC组大鼠缺血侧后肢;(3)EPC组(n=6),将体外培养的8×106个EPC植入EPC组大鼠缺血侧后肢。细胞移植后3周行大鼠后肢动脉造影,检测缺血侧后肢侧支血管数;切取缺血侧后肢腓肠肌,分别行CD31和α-SMA免疫组化染色,计算毛细血管密度和小动脉密度。结果MNC组毛细血管密度与EPC组差异无统计学意义[(31.67±7.87)个/HP vs.(32.83±5.38)个/HP,P>0.05],而均高于对照组(19.67±4.80个/HP)(P<0.05);MNC组侧支血管数与EPC组差异无统计学意义[(4.17±0.75)个vs.(4.50±1.38)个,P>0.05],但均高于对照组[(2.50±1.5)个](P<0.05);MNC组小动脉密度与EPC组差异无统计学意义[(4.83±1.47)个vs.(5.50±2.35)个,P>0.05],亦均高于对照组[(2.17±0.98)个](P<0.05)。结论在骨髓干细胞移植治疗肢体缺血性疾病中,非内皮祖细胞在血流重建中所起的作用与EPC相似。
