骨髓细胞移植对不同程度衰竭心脏功能恢复的研究

目的探讨骨髓干细胞移植(BMT)对哪种程度的心力衰竭更有效。方法结扎小型猪不同部位左前降支血管,造成不同程度心功能(左心室射血分数,LVEF)变化,2周后,将30只造模型成功动物随机分为3组,高LVEF(HLVEF,LVEF≥50%)组,中LVEF(MLVEF,50%>LVEF≥40%)组,低LVEF(LLVEF,LVEF<40%)组,每组分为两个亚组,各组随机经冠状动脉内移植骨髓单个核细胞或磷酸盐缓冲液(PBS),每组各5只动物。结果移植后4周,注射PBS动物LVEF呈进行性下降;而MLVEF+BMT组较移植前增加11.9%(P<0.05),明显高于HLVEF+BMT组和LLVEF+BMT组。冠状动脉造影显示,只有MLVEF+BMT组侧支循环数量较移植前有显著性增加。免疫组织化学显示,注射BMT的3组血管密度明显高于注射PBS的3组,以MLVEF+BMT组最明显。结论经冠状动脉内自体BMT更有利于中度心力衰竭受体心脏功能恢复和血流灌注改善。

Effect of bone marrow cell transplantation on recovery of the infarcted hearts with moderate heart failure

Objective To investigate which degree of heart failure may benefit most from bone marrow transplantation (BMT) for cardiac function improvement.Methods Different degrees of cardiac dysfunction were induced in swine by ligation of different segments of left anterior descending artery. Two weeks later, 1×10~8 bone marrow mononuclear cells or PBS were injected into the coronary artery of ischemic zone. Results Four weeks post-transplantation,left ventricular ejection fraction (LVEF) in PBS groups became gradually worse in comparison with pre-transplantation. LVEF in the moderate LVEF(MLVEF)+BMT group was significantly improved by 11.9% compared with pre-transplantation, and were greater than that in the high LVEF(HLVEF)+BMT and the low LVEF(LLVEF)+BMT groups (P<0.05). Coronary angiography showed that significant improvement of collateral circulation was only seen in the MLVEF+BMT group. Immunohistochemistry showed that the vessel counts in the BMT groups were significantly greater than those in the PBS groups, and the greatest vessel count was seen in the MLVEF+BMT group (P<0.05). Conclusions These data suggest that intracoronary transplantation of bone marrow stem cells benefits most the cardiac function recovery and blood supply improvement of infarcted hearts with moderate heart failure.