改善心肌原位干细胞治疗心肌梗死疗效的策略

虽然药物治疗、心脏介入手术及心脏搭桥手术等治疗心肌梗死（MI）的方法在不断改进，但MI仍然是全球范围内人类的主要死因。干细胞治疗作为一种可以替代梗死心肌细胞的治疗方法，已经进行了临床试验,但其改善心功能的效果十分有限。目前关于改善心肌原位干细胞（CSCs）治疗MI疗效的策略主要有：①选择更合适的CSCs;②用基因工程的方法处理CSCs；③采用不同导入CSCs的方法。本文就以上3种主要策略的最新研究进展、以CSCs治疗MI的机制以及目前存在的问题作一综述。

Strategies for improving effectiveness of cardiac stem cell therapy for myocardial infarction

Despite recent advances in medical therapy, reperfusion strategies, implantable cardioverter defibrillators and cardiac assistance devices, myocardial infarction （MI） remains a frequent cause of morbidity and mortality worldwide. Stem cell therapy has been introduced as a new treatment modality to regenerate lost cardiomyocytes. Cardiac stem cell （CSC） is one of the most hopeful types of stem cells to treat ischemic heart diseases. Although obvious improvement of left ventricular function has been reported in animal models, there are only moderate beneficial achievements clinically in myocardial regeneration. To date, strategies for improving effectiveness of cardiac stem cell therapy for myocardial infarction mainly include： 1） identification of the suitable CSCs; 2） gene engineering preconditioning of CSCs; and 3） development of methods to deliver CSCs into myocardium. Stem cell research and therapy will continue to provide novel approaches to diagnoses, therapies and tissue regeneration. In terms of the character of CSC and the mechanism of CSC therapy for MI, we review the recent developments of strategies to improve CSC therapy for MI and highlight the future goals and challenges that must be overcome.