骨髓单个核细胞移植治疗慢性心力衰竭的疗效观察

目的探讨自体骨髓单个核细胞移植治疗慢性心力衰竭患者的可行性。方法入选慢性心力衰竭患者80例，分为骨髓细胞移植组（48例）和标准药物治疗组（32例），骨髓细胞移植组将骨髓单个核细胞悬液在冠状动脉造影时经导管注入冠状动脉内。标准药物治疗组仅采用常规治疗。用超声心动图、血浆脑钠肽（BNP）和单光子发射计算机断层扫描（SPECT）比较两组治疗前后心功能指标和心肌灌注缺损区面积。结果骨髓细胞移植组和标准药物治疗组治疗前LVEF分别为（42．1±5．8）％、（43．9±6．7）％，术后1年随访分别为（54．1±4．8）％、（49．8±7．7）％；治疗前BNP分别为（699±101）ng／L、（687±95）ng／L，随访分别为（305±78）ng／L、（399±89）ng／L；治疗前心肌灌注缺损面积分别为（26．8±8．6）％、（26．3±6．5）％，随访分别为（15．8±4．3）％、（20．5±7．8）％，两组随访比较差异均有统计学意义；骨髓细胞移植组术中和术后均无并发症发生。结论骨髓单个核细胞移植治疗慢性心力衰竭患者安全可行，术后能改善心功能及心肌血流灌注。

Therapeutic effect observing of autologous bone marrow mononuclear cell transplantation on the patients with chronic heart failure

Objective To evaluate the efficacy of intracoronary autologous bone marrow mononuclear cell transplantation on the patients with chronic heart failure. Methods Eighty patients with chronic heart failure were assigned into bone marrow cell transplantation group （n = 48） and control group （n = 32）, with intracoronary delivery of autologous bone marrow mononuclear cell suspension or not respectively, in addition to conventional treatment. The left ventricular ejection fractions （LVEF）, the level of plasma brain natriuretic peptide（BNP）, and the sizes of myocardial perfusion defect were measured and compared with useing single photon emission computed tomography （SPECT） and echocardiography before and after the treatment. Results The one year follow-up results showed that LVEF increased from base-line （42.1 ± 5.8）%, （43.9 ± 6.7）% to （54.1 ± 4.8）%, （49.8 ± 7.7）% by echocardiography. The plasma levels of BNP decreased from base-line（699 ± 101 ）ng/L, （687 ± 95）ng/L to （305 ± 78）ng/L, （399 ± 89）ng/L, and the size of myocardial perfusion defect decreased from base-line （26.8 ± 8.6）%, （26.3 ± 6.5 ）% to （15.8 ± 4.3 ）%,（20.5 ± 7.8）% in bone marrow cell transplantation group and control group respectively, the absolute changes were statistitally significant. During and after the procedure of bone marrow cell transplantation group, there was no complication occurring. Conclusion Intracoronary autologous bone marrow mononuclear cell transplantation for treating patients with chronic heart failure results in improvement in left ventricular systolic function and myocardial perfusion, and this therapy is safe and feasible.