冠状动脉旁路移植术同期干细胞移植治疗冠心病慢性心衰的中期结果

目的利用冠状动脉旁路移植手术同期经冠状动脉桥血管内移植自体骨髓单个核细胞的方法治疗冠心病陈旧性心肌梗死伴慢性心功能不全患者,评价治疗的安全性和中期临床效果。方法选择需要外科手术治疗的冠心病陈旧心梗伴左室功能不全患者,应用冠状动脉旁路移植手术同期经冠状动脉桥血管内移植自体骨髓单个核细胞的治疗方法。评价干细胞移植后左室功能改变、不良事件、生存时间和中期随访情况。结果全组19例患者接受冠状动脉旁路移植术同期经冠状动脉桥血管内移植干细胞治疗。1例术后第3天因脑栓塞死亡。全组患者治疗后早期无心梗发生,无肝、肾功能衰竭,无新发恶性心律失常出现。18例患者平均随访2年全部存活,超声检测左室射血分数上升,心功能和心绞痛症状明显改善并具有统计学意义。结论冠状动脉旁路移植术同期经冠状动脉桥血管内移植自体骨髓单个核细胞治疗冠心病陈旧性心肌梗死的方法是可行的。手术后早、中期随访结果观察,此种治疗是安全的。

Midterm results of coronary artery bypass graft combined with autologous stem cell transplant treatment in chronic heart failure caused by coronary artery disease

Objective To use coronary artery bypass graft and autologous bone marrow mononuclear cell transplant to treat patients with heart failure caused by old myocardial infarction,and to evaluate the safety and intermediate stage clinical effect.Methods The change of left ventricular function,adverse events,life time and Midterm follow up information were evaluated in the patients with heart failure caused by old myocardial infarction who experienced coronary artery bypass graft and autologous bone marrow mononuclear cell transplant.Results 19 patients accepted the treatment of coronary artery bypass graft and autologous bone marrow mononuclear cell transplant.One died of postoperative cerebral embolism.No myocardial infarction,liver or renal failure,and no fresh malignant arrhythmia occurred.18 patients survived,left ventrical ejection fraction was raised.No change occurred in LVEDD, and heart function and the symptom of angina were obviously in proved and had statistical significance.Conclusion Using coronary artery bypass graft and autologous bone marrow mononuclear cell transplant to cure patients with heart failure caused by old myocardial infarction is feasible.The early metaphase follow up results showed that the method is safe.