摘要
背景:缺血性心脏病的传统治疗方法虽可暂时缓解病痛和改善生活质量,却无法使梗死的心肌修复再生,而干细胞具备的组织再生和多向分化潜能为缺血性心脏病的治疗带来新的契机。脐带间充质干细胞因具备极易分离提取、无免疫排斥、无伦理学争议以及较强的免疫调节作用等优势而成为治疗缺血性心脏病的理想候选种子细胞之一。目的:探讨人脐带间充质干细胞移植治疗缺血性心脏病3年的临床疗效。方法:入选2013年1月至2016年6月河北医科大学第一医院收治的冠心病患者8例,随机分为干细胞移植组和对照组,其中干细胞移植组4例行常规治疗并静脉输注人脐带间充质干细胞,对照组4例仅行常规治疗,3年后评估两组患者心功能、生化指标、心电图Ⅱ导联ST段的变化。所有入组患者均签署相关知情同意书,并经河北医科大学第一医院伦理委员会通过。结果与结论:治疗3年后,两组患者目前均存活。干细胞移植组左室射血分数和短轴缩短率分别较对照组均有升高趋势,但差异无显著性意义(P> 0.05),干细胞移植组治疗前后左室射血分数和短轴缩短率的差值分别较对照组显著升高(P <0.05),两组间心功能分级无显著变化。两组患者生化指标比较差异无显著性意义(P> 0.05),两组患者治疗前后不同导联心电图ST段的改变不同。该研究仅能表明人脐带间充质干细胞在一定程度上可以改善缺血性心脏病患者的心功能,而对心功能分级、生化指标无明显改善,对心电图各导联的影响不明确,故该治疗方法的意义有待进一步研究。
BACKGROUND:The traditional treatment methods for ischemic heart disease can temporarily relieve pain and improve the quality of life,but cannot restore and regenerate the myocardial tissue.Stem cells have been reported to possess the potential functions of tissue regeneration and multiplex differentiation characteristics which provide a new opportunity for the ischemic heart disease treatment.Because of the unique advantages of umbilical cord mesenchymal stem cells including easy separation,no immune rejection reaction,no ethical dilemmas and remarkable immunomodulatory effect,umbilical cord mesenchymal stem cells have been considered as one of the most ideal candidate seeds for the treatment of ischemic heart disease.OBJECTIVE:To investigate the clinical efficacy of umbilical cord mesenchymal stem cells transplantation in patients with ischemic heart disease in 3-year followup.METHODS:From January 2013 to June 2016,eight patients with coronary heart disease were admitted to the First Hospital of Hebei Medical University and randomly divided into stem cell transplantation group and control group.Four patients in the stem cell transplantation group received conventional treatment and intravenous infusion of umbilical cord mesenchymal stem cells.Four patients in the control group only received conventional treatment.At 3 years after treatment,cardiac function indexes,biochemical indexes and ST segment changes of electrocardiogram lead II were evaluated in two groups.All patients signed the informed consent.The experiment was approved by the Ethics Committee of First Hospital of Hebei Medical University.RESULTS AND CONCLUSION:Patients in each group were alive after 3 years.Compared with the control group,left ventricular ejection fraction and left ventricular fraction shortening displayed an increasing trend in the stem cell transplantation group(P>0.05).The changes of left ventricular ejection fraction and left ventricular fraction shortening indicated an important statistical improvement in the stem cell transplantation group compared with the control group(P<0.05).There was no significant improvement in New York Heart Association classification between the two groups.The biochemical indicators revealed no significant statistical difference between the two groups(P>0.05).ST segment changes of different electrocardiogram leads were various before and after treatment in both groups.This study can only show that human umbilical cord mesenchymal stem cells can improve the cardiac function of patients with ischemic heart disease to a certain extent,but there is no significant improvement in the classification of cardiac function,biochemical indicators,and the influence on electrocardiogram leads is not clear.Thus,the significance of this treatment method needs further study.
作者
荆宇澄
王乐
王宪云
魏梅
李敏
吉立双
马芳芳
刘刚
郑明奇
Jing Yucheng;Wang Le;Wang Xianyun;Wei Mei;Li Min;Ji Lishuang;Ma Fangfang;Liu Gang;Zheng Mingqi(Department of Cardiology,First Hospital of Hebei Medical University,Shijiazhuang 050031,Hebei Province,China;Cell Therapy Laboratory,First Hospital of Hebei Medical University,Shijiazhuang 050031,Hebei Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2021年第1期6-12,共7页
Chinese Journal of Tissue Engineering Research
基金
河北省科技计划项目(18272405D),项目负责人:王乐
河北省科技计划项目(19277757D),项目负责人:郑明奇
河北省自然科学青年基金项目(C2018206037),项目负责人:王宪云
河北省科技支撑计划重点项目(16277707D),项目负责人:刘刚
河北省卫生厅项目(20180224),项目负责人:王宪云。
关键词
干细胞
脐带间充质干细胞
缺血性心脏病
移植
心功能
心脏
随访
stem cells
umbilical cord mesenchymal stem cells
ischemic heart disease
transplantation
cardiac function
heart
follow-up
