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目的: 探讨动态三维超声心动图(DTDE)评价基因转染自体骨髓基质干细胞移植治疗慢性缺血心肌的价值。方法: 在猪冠脉左旋支放置Ameroid环建立慢性心肌缺血模型; 4周后分组注射编码血管生长素(ANG)基因的腺病毒转染的自体骨髓基质干细胞(组Ⅰ)、编码ANG基因的腺病毒液(组Ⅱ)、单纯自体骨髓基质干细胞(组Ⅲ)和空腺病毒磷酸盐缓冲液(组Ⅳ、对照组);再4周后行病理学检查。应用脱机DTDE重建和分析技术,观测正常、置环后4周及注射后4周左室形状、容积和收缩功能的变化。结果: 慢性缺血心肌左室舒张和收缩末期容积(LVEDV、LVESV)增大,射血分数(LVEF)降低(P<0. 01)。注射后,对照组LVEDV、LVESV较其它各组明显增大(P<0. 05),射血分数(LVEF)明显降低(P<0. 05),与缺血时无明显差异(P>0. 05)。组Ⅰ~Ⅲ较慢性缺血时LV EDV和LVESV均缩小(P<0. 05),LVEF均增大(P<0. 05),各治疗组比较,左室重构现象均不同程度地减轻,组Ⅰ较其它组,左室容积减小及收缩功能改善最为显著。组Ⅱ和Ⅲ间测值比较无统计学差异。结论: DTDE对评价基因转染自体骨髓基质干细胞移植治疗慢性缺血性心脏病具有重要价值。
Objective: To investigate the value of dynamic three-dimensional echocardiography (DTDE) evaluation gene transfection of autologous bone marrow stromal stem cells transplantation in the treatment of chronic ischemic myocardium. Methods: The model of chronic myocardial ischemia was established by placing the Ameroid ring on the left circumflex artery of swine coronary artery. After 4 weeks, adenovirus-transfected autologous bone marrow stromal stem cells encoding angiogenin (ANG) gene were grouped (group Ⅰ) Adenovirus solution (group Ⅱ), simple autologous bone marrow stromal stem cells (group Ⅲ) and empty adenovirus phosphate buffer (group Ⅳ, control group). Pathological examination was performed after 4 weeks. The offline DTDE reconstruction and analysis techniques were used to observe the change of left ventricular shape, volume and systolic function in normal, 4 weeks after ring placement and 4 weeks after injection. Results: Left ventricular diastolic and end-systolic volumes (LVEDV, LVESV) increased and LVEF decreased in chronic ischemic myocardium (P <0.01). After injection, LVEDV and LVESV in the control group were significantly higher than those in other groups (P <0.05), LVEF was significantly lower (P <0.05), and there was no significant difference between the two groups . 05). LVEDV and LVESV in group I ~ III were both decreased (P <0.05) and LVEF were increased in group C (P <0.05), LV remodeling were relieved to varying degrees in all treatment groups , Group Ⅰ than the other groups, the left ventricular volume decreased and systolic function to improve the most significant. There was no significant difference between groups Ⅱ and Ⅲ. Conclusion: DTDE is of great value in the evaluation of gene transfection of autologous bone marrow stromal stem cells for the treatment of chronic ischemic heart disease.