移植途径对骨髓间充质干细胞治疗心肌梗死的影响.pdf

移植途径对骨髓间充质干细胞治疗心肌梗死的影响中文提要移植途径对骨髓间充质干细胞治疗心肌梗死的影响中文提要目的对比研究经心外膜、冠状动脉及静脉注射三种不同途径移植骨髓问充质干细胞(MSCs)治疗心肌梗死的效果,探讨MSCs移植的最佳途径。方法用介入法栓塞冠状动脉左前降支的第二对角支远端建立猪心肌梗死模型,建模成功后将猪随机分为6组,每组5头。4周后进行自体MSCs移植,三个移植组分别经耳缘静脉、冠状动脉、心外膜注射用BrdU标记的MSCs悬液5ml(1×107),每组各设对照组,用同样方法注射DMEM培养液5ml。移植4周后行心脏超声及心脏磁共振检查,评价治疗心肌梗死的效果,组织学检查梗死区心肌形态改变及移植细胞在心肌内的分布情况。结果与对照组相比,三个移植组左室壁厚度增加、梗死区面积缩小、心功能显著改善(尸<),心外膜和冠状动脉移植组各项指标的改善比静脉移植组更明显(尸<),而它们两者之间没有差异(尸>)。移植组梗死区组织瘢痕化较轻,且均可见BrdU标记阳性的MSCs,心外膜和冠脉移植组中BrdU标记阳性的MSCs要多于静脉移植组。结论三种途径移植MSCs均能改善心肌梗死后的心功能;心外膜注射和冠状动脉注射的治疗效果比静脉注射更好;冠状动脉注射是MSCs移植治疗心肌梗死的最佳途径。关键词骨髓间充质干细胞;心肌梗死;移植;途径作者:蒋堪秋指导教师:钱永跃Effectsofdifferentwaysofbonemarrow-derivedmesenchymalstemtransplantationmyocardialmfarctionAbstractEffectsofdifferentwaysofbonemarrow-·parethetherapeuticeffectivenessoftransplantingbonemarrow-derivedmesenchymalstemcells(MSCs)intheheartofmyocardialinfarction(MI)viaextraepicardial、,:5ml(1×107)MSCssuspensionWasinjecteddirectlyintotheMIregionofeachswine;Intracoronaryinjectiongroup:5ml(1×107)MSCssuspensionWasiIljectedintocoronaryarteryofeachswine;Intravenousinjectiongroup:5ml(1×107)MSCssuspensionWasinjectedintoauricularveinofeachswine;3controlgroups:、,theleftventricularwallWasthicker,infarctareawassmallerandcardiacfunctionwassignificantlyimprovedinallMSCs—treatedanimals(P<).paredwithintravenousinjectiongroup,cardiacfunctionWasmoresignificantlyimprovedinbotllextraepicardialinjectionandintracoronaryinjectiongroup(尸<).However,therewasonsignificantstatisticaldifferencebetweenthesetwogr