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目的研究自体骨髓单个核细胞(BM-MNC)移植对小型猪心肌缺血再灌注损伤后心功能和梗死心肌的作用。方法结扎法建立心肌缺血再灌注损伤模型的16头小型猪,随机分为BM-MNC移植组(n=9)和磷酸盐缓冲液对照组(n=7),分别经冠状动脉移植(3.54±0.90)×108个BM-MNC细胞或磷酸盐缓冲液,对比移植4周时超声心动图、血液动力学、新生血管密度和心肌梗死面积的变化。结果BM-MNC组在细胞移植4周后左心室射血分数(LVEF)、室间隔、侧壁、前间壁厚度、心输出量和+dp/dtmax与细胞移植前比较,差异均无显著性(P>0.05)。对照组在细胞移植4周后,LVEF显著降低,室间隔、侧壁、前间壁显著变薄,心输出量和+dp/dtmax显著降低(P均<0.05)。舒张功能的指标在细胞移植前后各组变化不明显(P>0.05)。BM-MNC组缺血再灌注区的小血管数目为(13.39±6.96)个/高倍视野,显著高于对照组的(3.50±1.90)个/高倍视野(P<0.05)。BM-MNC组总心肌梗死面积和心肌梗死百分比均较对照组显著减少(P<0.05)。结论缺血再灌注区移植的BM-MNC可增加移植区新生小血管数目,减少心肌梗死面积,对改善心脏收缩功能起到一定作用。
Objective To investigate the effects of autologous bone marrow mononuclear cells (BM-MNC) transplantation on cardiac function and myocardial infarction in mini-pigs with myocardial ischemia-reperfusion injury. Methods 16 miniature pigs with myocardial ischemia reperfusion injury model were established by ligation. They were randomly divided into three groups: BM-MNC transplantation group (n = 9) and phosphate buffered saline control group (n = 7) ± 0.90) × 108 BM-MNC cells or phosphate buffer, compared with the change of echocardiography, hemodynamics, neovascular density and myocardial infarct size at 4 weeks after transplantation. Results The left ventricular ejection fraction (LVEF), interventricular septum, lateral wall, anteroseptal thickness, cardiac output and + dp / dtmax of BM-MNC group after 4-week cell transplantation were not significantly different from those before transplantation P> 0.05). After 4 weeks of transplantation, the LVEF of the control group was significantly decreased. The ventricular septum, lateral wall and anterior wall were significantly thinner, and the cardiac output and + dp / dtmax were significantly decreased (all P <0.05). The indexes of diastolic function did not change obviously in each group before and after cell transplantation (P> 0.05). The number of small blood vessels in ischemia-reperfusion area in BM-MNC group was (13.39 ± 6.96) / high power and significantly higher than that in control group (3.50 ± 1.90) / high power field (P <0.05). The total area of myocardial infarction and the percentage of myocardial infarction in BM-MNC group were significantly lower than those in control group (P <0.05). Conclusion BM-MNC transplanted in ischemia-reperfusion area can increase the number of newborn blood vessels in transplantation area, reduce the area of myocardial infarction and play a role in improving cardiac contractile function.