人脐血单个核细胞移植治疗心肌梗死合并心力衰竭

背景：多项基础研究证实人脐血干细胞治疗急性心肌梗死合并心力衰竭安全有效,但目前尚未有该方法用于临床治疗的报道。目的：观察人脐血单个核细胞移植治疗心肌梗死合并心力衰竭患者的远期疗效。方法：入选2009年1月至2011年6月辽宁中医药大学心血管内科收治的心肌梗死合并心力衰竭患者共25例,其中12例患者冠脉造影后通过微导管将脐血单个核细胞悬液注入到冠状动脉远端,13例患者进行常规治疗。所有患者均规范应用药物治疗,急性期均行冠脉造影及经皮冠状动脉介入治疗。治疗前,治疗后12,24个月观察两组患者心功能改善情况,评价指标为左室射血分数、左室收缩末期容积及左室舒张末期容积。结果与结论：与治疗前比较,移植组治疗后12,24个月左室射血分数显著增高,左室收缩末期容积、左室舒张末期容积显著降低（P〈0.05）。与治疗前比较,对照组治疗后12,24个月左室射血分数、左室收缩末期容积、左室舒张末期容积差异均无显著性意义（P〉0.05）。与对照组相比较,移植组各个时间点左室舒张末容积、左室收缩末容积均显著降低,左室射血分数增高（P〈0.05）。各随访期间均未发现相关不良事件发生。结果表明利用人脐血单个核细胞移植治疗心肌梗死合并心力衰竭,可显著改善患者心功能及左室重构情况。

Transplantation of human umbilical cord blood mononuclear cells for treatment of myocardial infarction with heart failure

BACKGROUND： Increasing basic researches have confirmed that human umbilical cord blood stem cells is safe and effective to treat acute myocardial infarction complicated by heart failure, but this method is not yet available for clinical use. OBJECTIVE： To observe the long-term effect of human umbilical cord blood fnononuclear cell transplantation in the treatment of myocardial infarction combined with heart failure. METHODS： Twenty-five patients with myocardial infarction and heart failure admitted in the Department of Cardiology, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, from January 2009 to June 2011 were randomly assigned to receive intracoronary transplantation of human umbilical cord blood mononuclear cells in addition to conventional therapy （transplantation group, n= 12） or standard therapy （control group, n=13）. All patients underwent standardized drug therapy, and coronary angiography and peroutaneous coronary intervention were performed at acute phase. Improvement in heart function, left ventricular ejection fraction, left ventricular end-systolic volume and left ventricular end-diastolic volume at baseline and 12, 24 months after treatment were monitored. RESULTS AND CONCLUSION： The left ventdcular ejection fraction, left ventricular end-systolic volume and left ventricular end-diastolic volume were significantly improved 12, 24 months after human umbilical cord blood stem cell transplantation compared to baseline （P 〈 0.05）, while these parameters remained unchanged in the control group （P 〉0.05）. Compared with the control group, the left ventricular ejection fraction was increased significantly, and the left ventdcular end-systolic volume and left ventdcular end-diastolic volume were reduced significantly in the transplantation group. During the follow-up, no side effects were observed. These findings indicate that human umbilical cord blood mononuclear cell transplantation leads to significant and longstanding improvements in left ventric