[1]赵先锋,徐　予,朱中玉,等.脐带间充质干细胞治疗慢性扩张型心肌病合并心力衰竭疗效观察[J].新乡医学院学报,2017,34(9):823-826.[doi:10.7683/xxyxyxb.2017.09.011]
　ZHAO Xian-feng,XU Yu,ZHU Zhong-yu,et al.Clinical efficacy of umbilical cord mesenchymal stem cells for treatment of chronic dilated cardiomyopathy complicated with systolic heart failure[J].Journal of Xinxiang Medical University,2017,34(9):823-826.[doi:10.7683/xxyxyxb.2017.09.011]
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脐带间充质干细胞治疗慢性扩张型心肌病合并心力衰竭疗效观察
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
34
期数:
2017年9
页码:
823-826
栏目:
临床研究
出版日期:
2017-09-05

文章信息/Info

Title:
Clinical efficacy of umbilical cord mesenchymal stem cells for treatment of chronic dilated cardiomyopathy complicated with systolic heart failure
作者:
赵先锋; 徐　予; 朱中玉;  高传玉
（河南省人民医院心血管内科　河南省心血管病医院，河南　郑州　450003)
Author(s):
ZHAO Xian-feng; XU Yu; ZHU Zhong-yu; GAO Chuan-yu
（Department of Cardiovascular Medicine，Henan Provincial People′s Hospital；Henan Provincial Cardiovascular Hospital，Zhengzhou 450003，Henan Province，China）
关键词:
脐带间充质干细胞; 扩张型心肌病; 心力衰竭; 有效性
Keywords:
umbilical cord mesenchymal stem cells; dilated cardiomyopathy; heart failure; validity
分类号:
R458.8
DOI:
10.7683/xxyxyxb.2017.09.011
文献标志码:
A
摘要:
目的　评价脐带间充质干细胞（MSCs）治疗慢性扩张型心肌病合并收缩性心力衰竭患者的临床效果。方法　选择2013年12月至2014年12月河南省人民医院收治的59例扩张型心肌病合并收缩性心力衰竭患者，将患者分为治疗组（30例）和对照组（29例）。治疗组患者在药物治疗基础上经冠状动脉注入脐带MSCs 20 mL；对照组患者在药物治疗基础上经冠状动脉注入等量生理盐水。治疗后1、6个月观察2组患者心功能变化、左心室射血分数（LVEF）、左心室舒张末期内径（LVEDD）、6 min步行距离、血清氨基末端脑钠肽前体（NT-proBNP）和再次住院率、病死率。结果　2组患者治疗后1、6个月纽约心脏病协会（NYHA）心功能分级较治疗前均有所改善（P<0.05）；治疗后1、6个月治疗组患者NYHA心功能分级均显著优于对照组（χ2=12.64、16.75，P<0.05)。治疗前2组患者LVEDD、LVEF、血清NT-proBNP 和 6 min步行距离比较差异均无统计学意义（P>0.05)；2组患者治疗后1、6个月LVEDD、LVEF、血清NT-proBNP 和 6 min步行距离与治疗前比较差异均有统计学意义（P<0.05)；治疗后1个月治疗组患者LVEDD与对照组比较差异无统计学意义（P>0.05），LVEF、6 min步行距离较对照组显著增加，血清NT-proBNP水平较对照组显著降低（P<0.05)；治疗后6个月治疗组患者LVEDD、血清NT-proBNP水平较对照组显著降低， LVEF、6 min 步行距离较对照组显著增加（P<0.05)。6个月随访结果显示，对照组患者病死率为24.14%（7/29），治疗组患者病死率为6.67%（2/30），治疗组患者病死率显著低于对照组（χ2=4.99，P<0.05)；对照组患者的再次住院率为31.03%（9/29），治疗组患者的再次住院率为16.67%（5/30），2组患者再次住院率比较差异无统计学意义（χ2=1.68，P>0.05）。结论　脐带MSCs可改善慢性扩张型心肌病合并心力衰竭患者的心功能和心室重构，降低短期病死率。
Abstract:
Objective　To evaluate the clinical effect of umbilical cord mesenchymal stem cells （MSCs）for treatment of chronic dilated cardiomyopathy complicated with systolic heart failure.Methods　Fifty-nine patients with chronic dilated cardiomyopathy and systolic heart failure in Henan Provincial People′s Hospital from December 2013 and December 2014 were selected and divided into treatment group（n=30)and control group （n=29).All patients were given routine drug treatment.Based on this，the patients in treatment group were given umbilical cord MSCs 20mL by intracoronary transplantation；the patients in control group were given the same volume of saline.The changes of cardiac function，left ventricular ejection fraction（LVEF)，left ventricular end diastolic diameter（LVEDD），6 minutes walking distance，the amino-terminal pro-brain natriuretic peptide（NT-proBNP) levels，the re-hospitalization rate，mortality rate of patients in the two groups were observed and compared at 1 month and 6 months after treatment.Results　The cardiac function grading of the New York Heart Association （NYHA) of patients in the two groups were improved at 1 month and 6 months after treatment（P<0.05）；the NYHA cardiac function grading of patients in the treatment group was significantly better than that in the control group at 1 month and 6 months after treatment （χ2=12.64，16.75；P<0.05).There was no statistic difference in LVEDD，LVEF，serum level of NT-proBNP and 6-min walking distance of patients between the two groups before treatment （P>0.05）.There was statistic difference in LVEDD，LVEF，serum level of NT-proBNP and 6-min walking distance of patients in the two groups before treatment and 1 month，6 months after treatment（P>0.05).There was no statistic difference in LVEDD of patients between the two groups at 1 month after treatment（P>0.05）；the LVEF，6-min walking distance of patients in the treatment group were significantly higher than those in the control group，but the serum level of NT-proBNP of patients in the treatment group was significantly lower than that in the control group at 1 month after treatment （P<0.05).At 6 months after treatment，the LVEDD，serum level of NT-proBNP of patients in the treatment group were significantly lower than those in the control group，but the LVEF and 6-min walking distance of patients in the treatment group were significantly higher than those in the control group （P<0.05).The mortality rate of patients in the treatment group（6.67%，2/30)was significantly lower than that in the control group（24.14%，7/29) （χ2=4.99，P<0.05).The re-hospitalization rate of patients in the treatment group and control group was 16.67%（5/30) and 31.03%（9/29) respectively；there was no statistic difference in the re-hospitalization rate of patients between the two groups （χ2=1.68，P>0.05).Conclusion　Umbilical cord MSCs can improve the cardiac function and cardiac remodeling，reduce the mortality rate of patients with chronic dilated cardiomyopathy complicated with systolic heart failure.

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更新日期/Last Update: 2017-09-05