定量组织多普勒评价急性心肌梗死自体骨髓干细胞移植联合激光血运重建术的实验研究

目的应用定量组织多普勒观察自体骨髓间充质干细胞（MSC）移植联合激光血运重建术（TMLR）治疗急性心肌缺血效果。方法建立32只新西兰大白兔急性心肌梗死模型，分为对照组、MSC移植组、TMLR组及联合治疗组，于心肌梗死前、心肌梗死后及治疗后测定射血分数（EF）、室间隔基底段及心尖段的位移（D）和应变（S）。治疗后4周处死动物行双重免疫组化染色检查及测量毛细血管密度。结果心肌梗死后EF、梗死部位D及S值显著下降。治疗后，MSC移植组及联合治疗组EF、梗死部位D及S值治疗后显著改善，病理学检查可见双染阳性细胞；其余两组未见双染阳性细胞，治疗后心功能无改善。联合治疗组毛细血管密度高于其他各组。结论MSC移植能够改善急性心肌梗死后心肌收缩功能，TMLR未增强MSC移植疗效，定量组织多普勒能够敏感评价心肌功能变化。

Experiment study of quantitative tissue Doppler evaluation on treatment of acute myocardial ischemia with autologous transplantation of mesenchymal stem cell combined with transmyocardium laser revascularization

Objective To evaluate the effect of autologous mesenchymal stem cell(MSC) transplantation with transmyocardial laser revascularization(TMLR) on acute myocardium infarction by quantitative tissue Doppler imaging(TDI). Methods Acute myocardium infarction(AMI) was created in 32 rabbits, randomly divided into control group, MSC group, TMLR group and combination group. Ejection fraction(EF), displacement(D) and strain(S) of septal basic and apical segment were detected before AMI and after AMI and treatment. Double immunohistochemistry and anti-CD146 staining were applied 4 weeks later. Results EF, apical D and S declined after AMI, and improved in MSC and combination group. Positive cells of double staining were found in the above two groups. The density of capillary vessels in combined group was significantly increased than other groups. Conclusions MSC transplantation can increase ischemic myocardium function without improvement combined with TMLR. Displacement and strain can quantitatively detect and evaluate the myocardium function.