自体心脏干细胞移植治疗缺血性心肌病的进展

背景：药物、介入或外科治疗均不能从根本上解决心脏缺血梗死后心肌细胞丧失问题.大量研究结果显示自体心脏干细胞移植治疗缺血性心肌病安全可行,可减少梗死瘢痕面积、改善心室重构、提高心脏功能.目前自体心脏干细胞移植治疗缺血性心肌病已进入临床试验阶段.目的：综述近年国内外自体心脏干细胞移植治疗缺血性心肌病的研究进展.方法：第一作者应用计算机检索1998年1月至2012年4月PubMed数据库、中国期刊全文数据库相关文章,英文检索词“autologous, cardiac stem cel s, ischemic cardiomyopathy, transplantation, treatment”;中文检索词“自体,心脏干细胞,缺血性心肌病,移植,治疗”.共检索到82篇相关文献,57篇文献符合纳入标准.结果与结论：经过大量小动物实验和大型动物的前临床实验准备阶段,目前自体心脏干细胞移植治疗缺血性心肌病已经进入临床试验阶段,初步临床试验结果显示自体心脏干细胞移植治疗缺血性心肌病安全、可行、有效.从心脏中分离的心脏干细胞移植到自体缺血梗死的心脏,可以分化生成心肌细胞、内皮细胞、平滑肌细胞,抑制心室重构,改善心脏收缩、舒张功能.相对于其他来源的干细胞移植治疗,自体心脏干细胞移植治疗缺血性心肌病无免疫源性,不存在免疫排斥反应;不存在伦理问题;其趋向分化成心脏细胞系,成瘤率低,相对安全.自体心脏干细胞移植为缺血性心肌病的治疗提供了一条新的途径,有更高的临床应用价值.但目前开展的临床试验较少,观测时间不够长,缺少多中心大样本量的临床试验等,这些都需要进一步研究探索.

Research progress in autologous cardiac stem cell transplantation for treatment of ischemic cardiomyopathy

BACKGROUND：Drugs, interventional or surgical treatment cannot fundamental y solve the loss of myocardial cel s after ischemic infarction. Many studies have shown that autologous cardiac stem cel s transplantation for treatment of ischemic cardiomyopathy is safe and feasible, and it can produce the neonatal cardiac myocytes, reduce the size of infarct scar, inhibit the ventricular remodeling and improve cardiac function. At present, autologous cardiac stem cel s transplantation for treatment of ischemic cardiomyopathy has entered clinical trials. OBJECTIVE：To summarize the research progress of autologous cardiac stem cel s transplantation for treatment of ischemic cardiomyopathy at home and abroad in recent years. METHODS：The first author retrieved PubMed database and China Academic Journal article from January 1998 to April 2012 using computer. The key words were＂autologous, cardiac stem cel s, ischemic cardiomyopathy, transplantation, treatment＂. We retrieved 82 articles, and 57 articles were included in the review. RESULTS AND CONCLUSION：Transplantation of cardiac stem cel s derived from autologous heart tissue to the ischemic infarction region of the heart can differentiate and generate new cardiomyocytes as wel as endothelial cel s, inhibit ventricular remodeling, and improve cardiac regional systolic and diastolic function. Transplantation of autologous cardiac stem cel s provides a new therapeutic approach for the treatment of ischemic cardiomyopathy. Compared to other sources of stem cel s, transplantation of autologous cardiac stem cel s for treatment of ischemic cardiomyopathy has higher clinical value.