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目的:探讨骨髓基质细胞(BMSCs)结合血管内皮生长因子(VEGF)基因心内膜注射治疗猪慢性心肌缺血模型的疗效。方法:建立猪心肌梗塞模型,胸骨穿刺抽取骨髓,分离培养BMSCs,将VEGF165基因转染到BMSCs中,4周后进行左室心内膜电机械标测并行心内膜注射等操作,按照注射成分不同分为3组,联合组(n=8)注射转染VEGF165基因的BMSCs,细胞组(n=8)注射BMSCs,对照组(n=6)注射生理盐水。于细胞移植后4周分别进行左室心内膜电机械标测、选择性冠脉造影及超声心动图检查。结果:术后4周时联合组较细胞组及对照组的心梗面积明显缩小,侧支循环、心脏泵血功能以及心肌收缩力改善更加明显(P<0.05～<0.01)。结论:自体BMSCs结合VEGF165基因治疗心肌梗塞效果显著。
Objective: To investigate the therapeutic effect of bone marrow stromal cells (BMSCs) combined with endocardial injection of vascular endothelial growth factor (VEGF) gene on chronic myocardial ischemia in pigs. Methods: Porcine model of myocardial infarction was established. Bone marrow was obtained by sternal puncture. BMSCs were isolated and cultured. VEGF165 gene was transfected into BMSCs. Four weeks later, endocardial electrocardiogram (LV) electromechanical mapping and endocardial injection were performed. BMSCs transfected with VEGF165 gene were injected intraperitoneally into three groups (n = 8). BMSCs were injected into the cell group (n = 8) and normal saline was injected into the control group (n = 6). Four weeks after cell transplantation, left ventricular endocardial electromechanical mapping, selective coronary angiography and echocardiography were performed. Results: Compared with the control group and the infarction group, the area of myocardial infarction in the combined group was significantly reduced at 4 weeks after operation. The collateral circulation, cardiac pumping function and myocardial contractility were more obvious (P <0.05 ~ <0.01). Conclusion: The combination of autologous BMSCs and VEGF165 gene has a significant effect on myocardial infarction.