兔缺血心肌中移植自体骨髓基质干细胞的治疗作用.docx

兔缺血心肌中移植自体骨髓基质干细胞的治疗作用【关键词】缺血心肌Autologousmarrowstromalcelltransplantationforimprovingrabbitcardiacperformanceaftermyocardialinfarction【Abstract】AIM:Totestthehypothesisthatmarrowstromalcells(MSCs)whenimplantedintoselfmyocardiumcanundergomilieudependentdifferentiationexpresscardiomyogenicphenotypesandenhanceangiogenesisandcardiacfunctionofischemicheartsinvivo.METHODS:AcutemyocardialinfarctionwasinducedbyocclusionofleftanteriordescendingarteryandautologousMSCslabeledwithBrdU(Bromodeoxyuridine)invitrowereadministratedintramyocardiallyintotheinfarctareaofthesamedonorrabbits.RESULTS:After4weekstransplantedMSCsdemonstratedmyogenicdifferentiationwiththeexpressionofαsarcomericactinandconnexin43.MSCsdisplayedincreasedlevelsofVEGFprotein［(684±86)fg/Lvs(515±51)fg/LP<0.05］andthenumberofvessels［(22.9±6.6)/HPvs(19.0±5.9)/HPP<0.05］inmyocardialischemiaareacomparedwiththoseincontrols.MSCsimplantationresultedinmarkedlyimprovedleftventricularcontractility［LVSP:(15.08±0.84)kPavs(13.26±0.68)kPa;LVEDP:(1.53±0.28)kPavs(19.03±0.41)kPa;+dp/dtmax:(+615.77±48.69)kPa/svs(+435.75±58.25)kPa/s;-dp/dtmax:(-401.17±46.23)kPa/svs(-338.25±50.72)kPa/sP<0.05］.CONCLUSION:AutologousMSCstransplantationcaneffectivelytreatmyocardialischemiawithoutimmunerejection.【Keywords】marrowstromalcell；ischemicmyocardium；transplantation【摘要】目的：验证骨髓基质干细胞（MSC）移植到缺血心肌中后是否在心肌的微环境中可以向心肌细胞分化提高心功能.方法：采用自体MSC体外培养扩增移植.在通过结扎冠状动脉造成急性心肌缺血后被5溴2脱氧尿苷（BrdU）标记后的MSC移植到自体的缺血心肌中.结果：移植4wk后MSC向肌细胞分化表达出α横纹肌肌动蛋白（sarcomericactin）和存在于闰盘中的connexin43移植后心肌表达VEGF增加［(684±86)fg/Lvs(515±51）fg/LP<0.05］缺血心肌局部血管密度增加［(22.9±6.6)/HPvs(19.0±5.9)/HPP<0.05］左室收缩功能明显强于对照组［LVSP:（15.08±0.84）kPavs（13.26±0.68）kPa;LVEDP:（1.53±0.28）kPavs（19.03±0.41）kPa;+dp/dtmax:（+615.77±48.69）kPa/svs（+435.75±58.25）kPa/s;-dp/dtmax:（-401.17±46.23）kPa