急性心肌梗死患者PCI术后骨髓干细胞动员疗效观察

目的探讨骨髓干细胞动员对合并粒细胞减少的急性心肌梗死患者左室功能的影响。方法选取23例急性ST段抬高型心肌梗死患者，分为粒细胞集落刺激因子（G-CSF）组和对照组，均在经皮冠状动脉介入治疗（PCI）后继续接受常规规范治疗，G-CSF组在此基础上给予G-CSF 10μg／kg皮下注射，1次／d，连续7d。住院及随访期间行超声心动图检查，6个月后复查冠状动脉造影。结果两组患者治疗前左室功能相关指标梗死区室壁增厚率、梗死区室壁运动评分指数（WMSI of IS）、左室舒张末期容积、左室射血分数（LVEF）]的差异均无统计学意义（均P〉0．05）；治疗6个月后，除对照组WMSIofIS外，其他指标较之治疗前均明显改变，差异有统计学意义（均P〈0．05）。与对照组比较，仅G-CSF组LVEF明显升高，差异有统计学意义（P〈0．05），其他指标的差异均无统计学意义（均P〉O．05）。结论对于急性心肌梗死患者，在PCI后利用G-CSF进行干细胞动员，将有助于心脏整体功能的恢复。

Effects of bone marrow stem cell mobilization on cardiac function in patients with acute myocardial infarction and granulopenia after revascularization

Objective To investigate the safety and efficacy of bone marrow stem cell mobilization for patients with ST-elevation myocardial infarction （STEMI） after successful revascularization. Methods Twenty-three patients aged 68.7 ± 5.9 with STEMI and granulopenia underwent successful primary percutaneous coronary intervention within 12h after onset. Patients were randomized into G-CSF group who received G-CSF （10 μg/kg） for continuous 7d and control group who did not receive G-CSF. Echocardiography, angiography and adverse events were documented. Results There were no differences in mean wall thickening of infract segments （WT of IS）, wall motion score index of infract segments（WMSI of IS）, LVEDV and LVEF at baseline between two groups （P〉 0.05）. After 6 months follow-up, all above mentioned parameters ameliorated significantly in both groups comparing with baseline （P 〈 0.05 ）, except WMSI of IS in control group （P 〉 0.05）. The longitudinal variation of LVEF in G-CSF group was greater than that in control group （P〈 0.05）, but there were no significant differences in longitudinal variation of other parameters between two groups （P〉 0.05）. Conclusion Mobilization of stem cells after revascularization in patients with STEMI can offer a pragmatic strategy for recovery of myocardial global function.