| SPECT对自体外周血干细胞移植治疗心肌梗死疗效的评价 |
| 投稿时间：2015-11-18 修订日期：2015-12-07 点此下载全文 |
| 引用本文：李强,刘艳超,刘超,孟自力,刘永辉,贺延法.SPECT对自体外周血干细胞移植治疗心肌梗死疗效的评价[J].医学研究杂志,2016,45(7):30-32,35 |
| DOI：
10.11969/j.issn.1673-548X.2016.07.009 |
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| 基金项目:国家自然科学基金资助项目（30860279）；河北省医学科学研究重点课题计划（20120237） |
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| 中文摘要:目的 通过单光子发射型电子计算机断层显像术（SPECT）评价自体外周血干细胞移植（APBSCT）治疗心肌梗死的临床疗效。方法 自2012年1月～2015年2月就诊于河北省胸科医院心肌梗死患者76例，根据是否行APBSCT分为移植组46例、对照组30例。入选患者常规药物治疗，移植组冠状动脉旁路移植术（CABG）前5天，进行自体外周血干细胞（APBSC）的动员及扩增，CABG前1天进行APBSC采集。入选患者采取非体外循环下CABG，移植组经心外膜下及冠状动脉桥血管注入采集的APBSC。两组均在术前及术后6个月运用SPECT评价心肌灌注情况；运用超声心动图评价左心室形态、室壁节段运动指数（WMSI）及心功能指标。结果 术后6个月时两组与术前相比心肌灌注缺损面积减小，左心室舒张末期内径（LVDd）较术前明显减小，左心室射血分数（LVEF）较术前明显增高，WMSI较术前明显降低，差异有统计学意义（P<0.05）。移植组术后指标更优于对照组，差异有统计学意义（P<0.05）。结论 CABG同期APBSCT治疗心肌梗死能改善心肌血流灌注，SPECT对APBSCT治疗心肌梗死有较高的临床价值。 |
| 中文关键词:心肌梗死|干细胞|外周血|细胞移植|SPECT |
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| Clinical Effect of SPECT Imaging in Autologous Peripheral Blood Stem Cell Transplantation for Myocardial Infarction |
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| Abstract:Objective To assess the clinical effect of single-photon emission computed tomography (SPECT) imaging in autologous peripheral blood stem cell transplantation (APBSCT) for myocardial infarction. Methods Totally 76 patients with myocardial infarction treated in Chest Hospital of Hebei Province from January 2012 to February 2015 were divided into the transplantation group (n=46) and control group (n=30) on the basis of whether being treated with APBSCT. In addition to the therapy of conventional drug, the patients in the transplantation group were given the mobilization and expansion of autologous peripheral blood stem cell (APBSC) 5 days before the coronary artery bypass graft (CABG) and then APBSC was collected 1 day before CABG. The selected patients were given the off-pump CABG, while patients in the transplantation group were injected with the collected APBSC via the subepicardium and coronary arterial bridge vessel. The blood perfusion of myocardial ischemia was evaluated using SPECT on patients in both groups before the operation and 6 months after the operation. Besides, the echocardiography was employed to evaluate the left ventricular morphology, wall motion score index (WMSI) and index of cardiac function before and after the operation. Results Six months after CABG, the defect area of myocardial perfusion was decreased, the left ventricular end-diastolic diameter (LVDd) decreased, the left ventricular ejection fraction (LVEF) increased and WMSI decreased compared with the ones before the operation, with the statistical difference (P<0.05). The indices for patients in the transplantation group after the operation were significantly better than that in the control group, with the statistical difference (P<0.05). Conclusion The combined treatment of CABG and APBSCT myocardial infarction can improve the blood perfusion. SPECT has the high clinical value in APBSCT treatment for myocardial infarction. |
| keywords:Myocardial infarction|Stem cell|Peripheral blood|Cellular transplantation|SPECT |
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