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目的 观察急性心肌梗死 (AMI)患者外周血干细胞动员的可行性与安全性。方法 自 2 0 0 3年 11月至 2 0 0 4年 1月收治的 2 7例AMI患者 ,入院后在常规急性心肌梗死治疗 (药物与介入治疗 )基础上给予包涵体型G -CSF(商品名 :惠尔血 )或分泌型G -CSF(商品名 :金磊赛强 ) ,3 0 0～ 60 0 μg/d皮下注射 ,连续 5天 ,第 6日分离外周血干细胞 ,进行经皮经腔冠状动脉内移植自体外周血干细胞进一步治疗急性心肌梗死。在外周血干细胞动员时观察有无骨痛 ,乏力 ,皮疹 ,发热 ,胃肠道反应 (恶心、呕吐、便秘 ) ,心绞痛或心衰加重 ,及一些少见的、严重的并发症 :自发性脾破裂、严重化脓性感染、高凝状态、自身免疫性疾病等发生。结果 在外周血干细胞的动员期间不良反应发生率为 44 .4%( 12 /2 7) ;其中骨痛发生率为 18.5 %( 5 /2 7) ,低热约 11.1%( 3 /2 7) ,乏力约 7.4%( 2 /2 7) ,皮疹约 3 .7%( 1/2 7) ,心衰加重约 3 .7%( 1/2 7) ,无其他少见的、严重并发症发生。结论 急性心肌梗死患者行外周血干细胞动员时 ,无影响AMI病程的严重并发症发生 ,在AMI病人中应用G -CSF安全可行。
Objective To observe the feasibility and safety of peripheral blood stem cell mobilization in patients with acute myocardial infarction (AMI). Methods Twenty-seven patients with AMI who were admitted to our hospital from November 2003 to January 2004 were enrolled in this study. After admission, patients were given inclusion body G-CSF (trade name : Whirlpool blood) or secreted G-CSF (trade name: Jin Lei Saiqiang), 3000 ~ 60 0 μg / d subcutaneous injection for 5 days on the 6th day of separation of peripheral blood stem cells for percutaneous transluminal coronary Arterial transplantation of autologous peripheral blood stem cells for further treatment of acute myocardial infarction. In the mobilization of peripheral blood stem cells were observed for bone pain, fatigue, rash, fever, gastrointestinal reactions (nausea, vomiting, constipation), angina or heart failure, and some rare and serious complications: Spontaneous splenic rupture , Severe suppurative infection, hypercoagulable state, autoimmune diseases occur. Results The incidence of adverse reactions was 44.4% (12/27) during the mobilization of peripheral blood stem cells. The incidence of bone pain was 18.5% (5/27) and the fever was 11.1% (3/27) About 7.4% (2/27) of weakness, rash of about 3.7% (1/2 7), heart failure increased by about 3.7% (1/2 7), no other rare and serious complications occurred. Conclusions In patients with acute myocardial infarction, peripheral blood stem cell mobilization does not affect the serious complications of AMI. It is safe and feasible to use G-CSF in AMI patients.