骨髓单个核细胞移植治疗急性心肌梗死

目的探讨自体骨髓单个核细胞(BMMNCs)移植对急性心肌梗死后心脏功能及结构的影响。方法中国小型猪16头,随机分为对照组(n=6)及移植组(n=10)。建立急性心肌梗死模型后,分别注入BMMNCs/生理盐水。两组动物于术中监测血流动力学指标,术后进行影像学检查。移植组分别于2、4周后获取心脏标本,检测移植细胞标记物Hoechst33342。结果心梗4周后,移植组心梗范围较对照组显著缩小(P<0.01);血流动力学指标较对照组明显改善;局部室壁运动评分优于对照组,组间差异有统计学意义(P<0.05)。在术后2周获得的心肌标本内,可见多量Hoechst33342和MHC双阳性细胞。结论成体BMMNCs移植后,有可能抑止心室重构的发展,提高心室运动功能。

Treatment of myocardial infarction by autologous mononuclear bone marrow cell transplantation in a swine model

Objective To investigate whether implantation of autologous mononuclear bone marrow cells (BM-MNCs) results in sustained engraftment in a swine myocardial infarct model,and to evaluate the influences of transplanted BM-MNCs on cardiac function with imaging techniques.Methods Sixteen Chinese mini-swines were randomly divided into control group (n=6) and treated group (n=10).BM-MNCs were isolated from bone marrow aspirates in the treated group and labeled with Hoechst33342.Coronary ligation was performed to make a myocardial infarction (MI).Thirty min later the autologous BM-MNCs or saline was injected into the injured myocardium.Hemodynamic measurements were done during the surgical process.Magnetic resonance imaging (MRI) scans and Sestamibi technetium single-photon emission computed tomography (SPECT) were performed after implantation.Four weeks later,all animals were sacrificed except that 3 animals in the treated group were sacrificed 2 weeks after implantation.Histological characteristics of the heart were also studied.Results Compared with the control group,the hemodynamic status was significantly improved in the treated group.MRI showed that the MI volume and its proportion in LV were reduced in treated group,while enlarged in the control group (P=0.001).LVEF level was increased in both groups and animals in the treated group obtained better regional wall motion score than the control group (P=0.012).Hoechst33342 positive cells were found around and within the MI region in pigs sacrificed 2 weeks after implantation and some of them were positive stained to MHC.Conclusion Bone marrow mononuclear cells transplanted into the myocardial infarct region could prevent dilatation of the infarcted ventricle,improve regional and global cardiac function.