中国组织工程研究

中国组织工程研究 ›› 0, Vol. ›› Issue (0): 99-102.doi: 10.3969/j.issn.1673-8225.2012.01.021

• 骨髓干细胞 • 上一篇    下一篇

脐血单个核细胞移植治疗老年急性广泛前壁心肌梗死后心源性休克合并重度心力衰竭1例

张  明1，于  乐2     

  1. 1辽宁省金秋医院，辽宁省沈阳市  110016； 2辽宁中医药大学附属医院，辽宁省沈阳市  110032
  • 收稿日期:2011-09-03 修回日期:2011-12-09
  • 通讯作者: 于乐，硕士，主治医师。辽宁中医药大学附属医院，辽宁省沈阳市 110032 ylyylzxp@126.com
  • 作者简介:张明★，男，1950年生，黑龙江省齐齐哈尔市人，硕士，1982年上海医科大学毕业，汉族，主任医师，教授。 zhangming0918@126.com

Human umbilical cord blood mononuclear celltransplantation for extensive anterior-wall acutemyocardial infarction with cardiogenic shock and severeheart failure in one case

Zhang Ming1, Yu Le2
  

  1. 1Jinqiu Hospital of Liaoning Province, Shenyang  110016, Liaoning Province, China; 2Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang  110016, Liaoning Province, China
  • Received:2011-09-03 Revised:2011-12-09
  • Contact: Yu Le, Master, Attending physician, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang 110016, Liaoning Province, China ylyylzxp@126.com
  • About author:Zhang Ming★, Master, Chief physician, Professor, Jinqiu Hospital of Liaoning Province, Shenyang 110016, Liaoning Province, China zhangming0918@126.com

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被引次数

1

摘要：

背景：人脐血单个核细胞作为一类移植细胞日益引起关注，但多为基础研究。
目的：就脐血单个核细胞移植治疗老年急性广泛前壁心肌梗死后心源性休克合并重度心力衰竭1例进行报道。
方法：急性广泛前壁心肌梗死后心源性休克合并重度心力衰竭女性患者1例，经冠心病介入治疗置入3枚支架及内科药物系统治疗，仍有反复发作性呼吸困难等心力衰竭症状。使用冠脉微导管经左冠前降支将含有脐血单个核细胞2.4×108个，总计50 mL干细胞悬液注射到梗死相关血管。
结果与结论：干细胞移植后随访近4个月，患者无不良反应发生，心力衰竭症状明显好转。射血分数从术前22%，移植后42%，到移植后21 d升高至53%。血脑钠肽从术前1 730 ng/L，移植后854 ng/L，到移植后21 d降低至264 ng/L。移植后4个月患者无胸闷、气短、乏力、呼吸困难发生，可以从事日常活动。说明脐血单个核细胞移植治疗急性心肌梗死后心源性休克合并心力衰竭安全、有效。

关键词: 脐血单个核细胞, 细胞移植, 急性心肌梗死, 心力衰竭, 干细胞移植

Abstract:

BACKGROUND: Transplantation of the human umbilical cord blood mononuclear cells (HUCBCs) have received increasing attention, as a promising candidate for the cellular transplantation, but the majority of the existing studies are basic research.
OBJECTIVE: To report a patient of extensive anterior-wall acute myocardial infarction with cardiogenic shock and severe heart failure, after treatment of HUCBCs transplantation.
METHODS: A 73-year-old female patient with cardiogenic shock and severe heart failure after extensive anterior-wall acute myocardial infarction was treated with percutaneous coronary intervention (three scaffolds implantation) and medications, and she still appeared the symptoms of congestive heart failure, such as severe recurrent dyspnea. 2.4 × 108 HUCBCs (50 mL cell suspension) was injected into the infarcted myocardium through the left anterior descending artery by using coronary micro-guide catheter.
RESULTS AND CONCLUSION: The patient reported profound clinical benefit including improvement of heart-failure-associated symptoms after the transplantation. Notably the patient did not experience the cell transplant-related side effects during 4 months of follow-up. The ejection fraction increased from 22% before the transplantation to 53% at 21 days after the transplantation. The B-type natriuretic peptide decreased from 1 730 ng/L before the transplantation, 854 ng/L after the transplantation to 264 ng/L at 21 days after the transplantation. The patient did not appear the symptoms of congestive heart failure, including dyspnea, chest distress and hypodynamia, she returned to daily activity at 4 months of follow-ups. Experimental findings indicate that the HUCBCs transplantation is an effective and safe means for patients cardiogenic shock and severe heart failure after acute myocardial infarction

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