| Objective: The cardiovascular disease has become the first killer of human, acute myocardial infarction (AMI )and chronic cardiac insufficiency occupy more than 50% in the death rate of cardiovascular disease. After AMI eppecially the anterior wall AMI, myocardial cells loss and fibre scar tissues hyperblastosis induce the cardiac remodelling, this is the important cause of patients'heart function aggravation, even death. In the past few years, implantation technique has been developed and become the new way to cure AMI. This study through detecting inter- cellular adhesion molecule-1(ICAM-1),vascular endothelial cell adhesion molecule-1(VCAM-1),E-selection to estimate the endothelial function; through ECT of myocardium and floor walking test in 6 min to estimate the heart function, all of these is to confirm the safty and efficacy of mesenchymal stem cell transplantation in curing AMI.Methods: Select 40 AMI patients (23 are men, 17 are wemen) from Tang shan Gong ren hospital from June 2006 to October 2007, the selected standards are: Chest pain persists more than 30 minutes; there are more than 2 anterior wall leads preceding more than 0.2mv, CK-MB raises more than 2 times compare to the normal level, and from the beginning of AMI to open the criminal vascular, the time is within 6 hours. EF of echocardio -graphy is less than 40%. According to the patients'own idea, dicide into 2 groups: The transplanting group (group T), 20 persons, 12 are men, 8 are wemen, their average age is 63.7±7.2, these patients have emergent PCI to open the criminal vascular. 7-14 days later, after indentificating the informed consent they have the transplanting operation. The emergent PCI control group (group C), 20 persons, 11 are men, 9 are wemen, their average age is 64.3±7.5, those patients only have the emergent PCI to open the criminal vascular, without the transplanting operation. Both of the 2 groups have the same medicines, such as Plavix,aspirin,beta-blockade,ACEI and statins. We also select 20 healthy pesons as the normal group (group N), 10 are men, 10 are wemen, their average age is 62.4±10.7. The differences of age,sex composition,smoking,blood fat,hypertention,diabets and so on don't have statistically significant. The transplanting group draw ulnar vein blood 4ml 5 times: before PCI , after the operation of stem cells transplantation, 1, 3 months and 6 months after the transplanting operation. The only PCI group draw the same time blood accordingly,put the blood serum into -70℃refrigerator to wait for detecting. Use the enzyme linked immunosorbent assay (ELISA) to messure the level of sICAM-1, sVCAM-1 ,sE-selectin. The two groups have both ECT of myocardium and floor walking test in 6 minutes at the time of in hospital, 3 and 6 months after the transplanting operation.Results:1 sICAM-1:①Before PCI: The levels of group T and group C are much higher than group N, the difference has statistical significance (P<0.05). The difference in group T and group C doesn't have statistical significance (P>0.05).②After the transplanting operation: The levels of group T and group C are much higher than group N, the difference has statistical significance (P<0.05). The difference in group T and group C doesn't have statistical significance(P>0.05).③1 month after the transplanting operation: The levels of group T and group C are much higher than group N, the difference has statistical significance (P<0.05). Group T is lower than group C, the difference has statistical significance (P<0.05).④3 months after the transplanting operation: The levels of group T and group C are much higher than group N, the difference has statistical significance (P<0.05). Group T is lower than group C, the difference has statistical significance (P<0.05).⑤6 months after the transplanting operation: The difference in group T and group N doesn't have statistical significance (P>0.05). Both of them are lower than group C. The difference has statistical signifi- cance (P<0.05).2 sVCAM-1:①Before PCI: The levels of group T and group C are much higher than group N, the difference has statistical significance (P<0.05). The difference in group T and group C doesn't have statistical significance (P>0.05).②After the transplanting operation: The levels of group T and group C are much higher than group N, the difference has statistical significance (P<0.05). The difference in group T and group C doesn't have statistical significance(P>0.05).③1 month after the transplanting operation: The levels of group T and group C are much higher than group N, the difference has statistical significance (P<0.05). Group T is lower than group C, the difference has statistical significance (P<0.05).④3 months after the transplanting operation: The levels of group T and group C are much higher than group N, the difference has statistical significance (P<0.05). Group T is lower than group C, the difference has statistical significance (P<0.05).⑤6 months after the transplanting operation: The difference in group T and group C doesn't have statistical significance (P>0.05). Both of them are higher than group N. The difference has statistical signi- ficance (P<0.05).3 sE-selectin:①Before PCI: The levels of group T and group C are much higher than group N, the difference has statistical significance (P<0.05). The difference in group T and group C doesn't have statistical significance (P>0.05).②After the transplanting operation: The levels of group T and group C are much higher than group N, the difference has statistical significance (P<0.05). The difference in group T and group C doesn't have statistical significance (P>0.05).③1 month after the transplanting operation: The levels of group T and group C are much higher than group N, the difference has statistical significance (P<0.05). The difference in group T and group C doesn't have statistical significance (P>0.05).④3 months after the transplanting operation: The levels of group T and group C are much higher than group N, the difference has statistical significance (P<0.05). The difference in group T and group C doesn't have statistical significance (P>0.05).⑤6 months after the transplanting operation: The levels of group T and group C are much higher than group N, the difference has statistical significance (P<0.05). Group T is lower than group C, the difference has statistical significance (P<0.05).4 Compare groug T with group C, either before or 3months after operation, the amount of EF doesn't have obvious difference (P>0.05). 6 months after operation, the amount of EF in group T is higher than group C, they are 41.45±7.44%, 36.05±6.27%. The difference has statistical significance (P< 0.05) .5 Compare groug T with group C, either before or 3months after operation, the amount of floor walking test in 6 minutes doesnot have obvious difference (P>0.05). 6months after operation, the amount of floor walking test in 6 minutes in group T is higher than group C, they are 390.50±49.79m, 357.25±33.74m. The difference has statistical signi ficance (P<0.05).Conclusions: Mesenchymal stem cells transplantation will not make endothelial dysfunction worser, but may make beneficial on it. Mesenchymal stem cells transplantation can help with the recovery of the heart function of AMI patients.
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