自体骨髓单个核细胞移植治疗风湿性心脏病可行性研究

目的观察自体骨髓单个核细胞（BMMNCs）心肌内移植对风湿性心脏病患者心功能的影响，探讨其临床实用性。方法选取以左室扩大为主的风湿性心脏病患者5例，瓣膜置换手术当日采取髂骨骨髓20ml，同上法获得自体BMMNCs悬液备用。瓣膜置换完毕，于特定局部心肌内注入上述细胞悬液，分别于术前、术后1周及术后3个月行门控核素心血池显像（MGBP）检查，评价患者心功能及局部心肌舒缩能力，同时监测围手术期心电图及各项实验室指标。结果患者围手术期均未发现明显不良反应，术后3＋71反映左室收缩功能的各项指标显著升高，左室8个分区局部射血分数（rEF）亦明显升高，尤以S3～S6为著。结论自体BMMNCs心肌内移植方法简便、可靠，进一步的严格对照、多中心、随机双盲的大样本临床实验可以进行。

Feasibility of autologous transplantated bone marrow mononuclear cells on treatment of rheumatic heart disease

[Objective] To observe the the influence on heart function and potential side effects of the autologous intramyocardial transplanted bone marrow mononuclear cells(BMNNCs) in patients with rheumatic heart disease.[Methods] Five rheumatic heart disease patients were enrolled in this trail.Hip bone marrow (20 ml) was harvested just before the valve replacement operation.BMMNCs were isolated with the same method and were transplanted via direct injection when the valve replacement was finished.Multiple gated blood-pool imaging(MGBP) was preformed before operation and one week,three months after operation separately.Electrocardiogram and experimental parameters were also evaluated during peri-operation. [Results] During peri-operation,no remarkable side effect happened.Three months after operation,the left ventricular ejection fraction(LVEF),1/3 ejection fraction(1/3EF) and peak ejection rate(PER) improved significantly in comparson with the preoperative value;Left ventricular regional ejection fraction(rEF) also improved significantly,especially in the subarea of S_3-S_6.[Conclusions] It is convenient and reliable for the autologous BMMNCs intramyocardical transplantation that can be used in clinical trial.The subsequently BOOST randomized controlled clinical trial can be performed.