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目的应用组织多普勒成像(TDI)技术定量评价急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)后应用自体骨髓单个核细胞(BMMNC)移植后对左心室局部和整体功能的影响。方法分别选取24例男性AMI患者作为试验组及对照组,发病24 h内均接受PCI,试验组患者于术后7～14天内接受冠状动脉内自体骨髓间充质干细胞移植术。所有患者分别于术前、术后1个月、3个月及6个月接受常规超声心动图及TDI检查。常规超声心动图测量左心室射血分数(LVEF),TDI测量二尖瓣瓣环及左心室壁相应梗死部位心肌收缩期峰值速度(Sa、Sm)、舒张早期峰值速度(Ea、Em)、舒张晚期峰值速度(Aa、Am),比较不同时间点两组各指标的差异。结果试验组与对照组术前各项指标差异均无统计学意义。与对照组相比,试验组术后1个月、3个月及6个月Sa、Sm、Em、Ea/Aa及Em/Am均明显提高;术后3个月及6个月LVEF及Ea较对照组提高,差异均有统计学意义(P<0.05)。结论联合应用自体BMMNC移植较常规PCI更有助于AMI患者局部及整体收缩、舒张功能的改善;利用TDI可对其进行定量检测。
Objective To quantitatively evaluate the local and global function of left ventricular after autologous bone marrow mononuclear cells (BMMNC) transplantation in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) by using tissue Doppler imaging (TDI) . Methods Twenty-four male patients with AMI were selected as experimental group and control group, all undergoing PCI within 24 hours after onset. Patients in experimental group underwent intracoronary autologous bone marrow mesenchymal stem cell transplantation within 7-14 days after operation. All patients underwent echocardiography and TDI at preoperative, postoperative 1 month, 3 months and 6 months respectively. The left ventricular ejection fraction (LVEF) was measured by conventional echocardiography. The myocardial systolic peak velocity (Sa, Sm), early diastolic peak velocity (Ea, Em) and diastole Late peak velocity (Aa, Am), comparing different time points between the two groups of different indicators. Results There were no significant differences in preoperative indicators between the experimental group and the control group. Compared with the control group, the levels of Sa, Sm, Em, Ea / Aa and Em / Am in the experimental group were significantly increased at 1 month, 3 months and 6 months after operation; LVEF and Ea at 3 and 6 months after operation Compared with the control group, the differences were statistically significant (P <0.05). Conclusions The combination of autologous BMMNC transplantation with conventional PCI is more helpful for the improvement of local and global systolic and diastolic function in patients with AMI. Quantitative detection can be performed by using TDI.