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目的:探讨经外周静脉途径移植骨髓间质干细胞治疗急性心肌梗死的有效性和可能的机制。方法:采用左前降支冠状动脉结扎术制备大鼠心肌梗死模型,24h后经尾静脉注入同种异体骨髓间质干细胞或磷酸缓冲液;分别于移植后3d和1个月取材,应用ELISA和免疫组化技术分析细胞移植对血管内皮生长因子(VEGF)表达的影响,通过免疫组化染色观察移植细胞的分化情况并计数血管;超声心动图连续检测大鼠心功能在术后各时间点的变化。结果:细胞移植术后3d,移植组VEGF蛋白的表达量明显高于对照组(P<0.01),免疫组化显示移植组心脏的梗死区及其周边区域的细胞内VEGF阳性着色明显强于对照组,1个月时明显减弱。移植术后1个月,在部分移植细胞中检测到心肌细胞或血管内皮细胞特异性蛋白的表达,血管计数显示移植组血管数量较同期对照组增加1.4倍(P<0.01);同时移植组心功能较对照组明显改善(P<0.01)。结论:通过促进梗死周边缺血心肌的血管新生和移植细胞分化,骨髓间质干细胞经外周静脉移植可作为急性心肌梗死治疗的另一条有效路径。
Objective: To investigate the effectiveness and possible mechanism of transplanting bone marrow mesenchymal stem cells via peripheral vein to treat acute myocardial infarction. Methods: The model of myocardial infarction was established by ligation of the left anterior descending coronary artery in rats. Allogeneic bone marrow mesenchymal stem cells and phosphate buffered saline were injected into the caudal vein 24 h later. The cells were harvested at 3d and 1 month after transplantation. The effect of cell transplantation on the expression of vascular endothelial growth factor (VEGF) was analyzed by histochemistry. The differentiation of transplanted cells was observed by immunohistochemistry and the blood vessels were counted. The changes of cardiac function in rats at different time points were detected by echocardiography . Results: The expression of VEGF protein in the transplantation group was significantly higher than that in the control group (P <0.01) 3d after transplantation. Immunohistochemistry showed that the positive staining of VEGF in the infarcted area and its peripheral area in the transplantation group was significantly stronger than that in the control group Group, significantly reduced at 1 month. One month after transplantation, the expression of cardiomyocytes or vascular endothelial cell-specific proteins was detected in some of the transplanted cells. The number of blood vessels in the transplanted group was 1.4 times more than that in the control group (P <0.01) Function than the control group was significantly improved (P <0.01). CONCLUSIONS: Bone marrow mesenchymal stem cells can be used as another effective pathway for the treatment of acute myocardial infarction by promoting angiogenesis and transplanted cell differentiation in ischemic myocardium of infarcted area.