不同时间自体骨髓动员急性缺血心肌的血管再生☆

背景：正常组织在损伤后可动员骨髓干细胞至损伤组织，在局部微环境作用下定向增殖分化修复组织。 目的：应用集落刺激因子动员猪急性心肌梗死模型，观察骨髓动员对猪急性心肌梗死模型的心功能影响及新生血管的作用。 方法：健康太湖梅山猪15头，明胶海绵栓塞冠状动脉(左前降支)法建立猪缺血性心脏病-心肌梗死模型，随机分为3组。对照组建模后4周后经冠状动脉注射DMEM；立即动员组建模后3 h并连续5 d注射粒细胞集落刺激因子；1周动员组：建模1周后连续5 d注射粒细胞集落刺激因子。 结果与结论：与对照组相比，立即动员组和1周动员组射血分数、左室舒张期内径、左心室收缩期内径心功能指标均有改善。骨髓动员后，两组血清血管内皮生长因子水平上升明显，血管密度明显增加，对照组无明显变化。提示自体骨髓干细胞动员后可归巢到心肌受损区域，在局部环境诱导下可分化成原始的血管结构，参与缺血区的血管形成。 关键词：血管再生；缺血性心脏病；心力衰竭；骨髓间充质干细胞；粒细胞集落刺激因子 doi:10.3969/j.issn.1673-8225.2012.06.018

Effect of autologous bone marrow stem cells mobilization at different time points on vascular regeneration of acute ischemic myocardium

BACKGROUND: The bone marrow stem cells can be mobilized and migrate to the damage tissue after the normal tissue defect and can proliferate and differentiate and repair the damage tissue under local microenvironment. OBJECTIVE: To establish the acute ischemic myocardial infarction model of swines mobilized by colony-stimulating factor (CSF) and to study the effect of bone marrow mobilization on the cardiac function and vascular regeneration of acute myocardial infarction model. METHODS: Fifteen healthy Taihu Meishan swines were used to establish the ischemic myocardial infarction model mobilization in the distal end of the left anterior descending branch (LAD) with a gelatin sponge through cardiac catheter, and explore its mechanism initially. The swines were randomly divided into three groups: the control group, injected with DMEM through coronary artery at the 4th week after modeling; the immediate mobilization group, injected with granulocyte colony-stimulating factor (G-CSF) at the 3rd hour after modeling and last for 5 days; 1 week mobilization group, injected with G-CSF at the 1st week after modeling and last for 5 days. RESULTS AND CONCLUSION: Compared with control group, the functional parameter, such as ejection fraction, left ventricular internal dimension diastole and left ventricular internal dimension systole in immediate mobilization group and 1 week mobilization group were improved significantly. And after bone marrow mobilization, the serum levels of vascular endothelial growth factor (VEGF) in the two groups were significantly elevated, as well as the vascular density. There was no obvious difference in control group. Bone marrow stem cells were mobilized by G-CSF and migrated to the site of myocardial infarction, and differentiated into initial vascular structure, and take part in the vascular formation in ischemic myocardium.