复合bFGF缓释支架结合骨髓间充质干细胞移植对心梗后血管新生的研究

目的：探讨心肌机械钻孔结合复合碱性成纤维细胞生长因子（bFGF）的缓释支架及骨髓间充质干细胞（BMSCs）移植对心肌血运重建的作用。方法：建立猪急性心梗模型后,于缺血区进行直径3.0mm的透壁性钻孔再生血管术（drilling transmyocardial revascularization,TMDR）并置入等直径的缓释支架,在孔道周围分五点进行细胞移植。心梗模型建立后0.5h及术后6周行心肌核素显像检测。取术后6周的心肌标本进行病理组织学检测。结果：术后6周,与对照组相比,治疗组的新生血管密度及心肌局部血流灌注均显著增加（P〈0.001）,联合治疗组中上述指标明显高于支架或细胞单独治疗组（P〈0.05）。免疫荧光结果显示,联合治疗更有利于移植细胞存活,存活细胞分化成血管内皮细胞,参与新生血管网的形成。结论：复合bFGF的缓释支架及BMSCs移植可引发强烈的血管生成效应,减轻并改善缺血缺氧造成的心肌损伤,增强细胞移植的效果。

Experimental study of slow-release stent of bFGF and bone marrow stem cells implantation in myocardial infarction

Objective:To investigate the effects of drilling transmyocardial revascularization(TMDR)with slow-release stent of bFGF and bone marrow derived stem cell(BMSCs)transplantation on myocardium revascularization.Methods:Mini-swine was randomly assigned to establish models of acute myocardial infarction,subsequently received TMDR,stent implantation and cells transplantation in the infarction territory.Six weeks postoperatively,pathologic histology analysis was performed.Results:Six weeks post operatively vascular density was significantly improved in treated groups compared with control group(P<0.001);moreover,combined group showed further improvement than that of groups with stent implantation or cells transplantation alone(P<0.05).Histologically,cells were observed to differentiate into endothelial cells.Conclusion:Slow-release stent of bFGF and BMSCs transplantation can greatly promote neovascularization formation.