Study On The Mobilization,Collection And Transplantation Of Autologous Peripheral Blood Stem Cell For Myocardial Infarction Patients

Objective:Researching on the efficiency of the mobilization and collection of autologous peripheral blood stem cell(APBSC) for myocardial infarction patients;the safety and feasibility of myocardial infarction treatment via the autologous peripheral blood stem cell transplantation (APBSCT).Methods:From september 2007 to october 2008,a total of 16 patients who are suffering from myocardial infarction have been selected.After myocardial infarction patients are taken to the hospital with the therapy of conventional drug,5 days before coronary artery bypass graft (CABG),according to patient's weight,using of recombinant human granulocyte colonystimulating factor(rhG-CSF) 450μg/d or 600μg/d to subcutaneous injection carrys on the APBSC mobilization and expansion.24 hours before CABG,taking APBSC collection.Taking the product of APBSC collection and adding heparin sodium injection,keeps it in a refrigerator at 4 degrees celsius.16 patients take coronary artery bypass graft with noncardiopulmonary by pass,inject the collcetion of APBSC via bridge coronary vessels and subepicardial.During the period of APBSC mobilization,detecting peripheral routine blood test once a day,observing changes of WBC,monitoring changes of blood pressure,heart rate, respiratory,WBC,RBC,Hb,Hct,Plt and serum Ca²⁺,before and after APBSC mobilization. Before and after APBSC mobilization,collection and save,detecting the number of mononuclear cell(MNC) and CD34⁺ cell from the peripheral blood and acquisition products.It is observed that there is any adverse reaction in the process of APBSC mobilization,collection and transplantation.Results:Before and after APBSC mobilization,the numbers of WBC,MNC,CD34⁺ cell in peripheral blood have significantly increased(P＜0.001),The amount between WBC and MNC,WBC and CD34⁺ cell,CD34⁺ cell and MNC show positive correlation.Their correlation coefficient are r=0.869(P＜0.001),r=0.775(P＜0.001),r=0.914(P＜0.001).Before and after the peripheral blood stem cell collection,there is no statistical significance that the the blood pressure,heart rate,respiratory,WBC,RBC,Hb,Hot and serum Ca²⁺(p＜0.05),the difference of the number of Plt has statistical significance(P＜0.001).Compared with the number of MNC and CD34⁺ cell in peripheral blood before collection.it has significantly increased(P＜0.001),in APBSC acquisition products.the amount between the CD34⁺ cell of the peripheral blood before collection and MNC of the product after collection,the CD34⁺ cell and MNC of the product after collection show positive correlation.Two correlation coefficient are r=0.818(P＜0.001),r=0.857(P＜0.001).Before and after saveing of APBSC acquisition products,the differences of the number of MNC and CD34⁺ cell have statistical significance, but they have little change(P＜0.001).There are total 12 cases take adverse reaction, during the process of APBSC mobilization,collection and transplantation,the adverse reaction in the process of APBSC mobilization takes 31.25%(5/16),the adverse reaction during APBSC collection takes 18.75%(3/16),the adverse reaction in the process of APBSC transplantation takes 25.00%(4/16).Conclusion:Myocardial infarction patients can obtain much more MNC and CD34⁺ cell after APBSC mobilization and collection;It's safy and feasible to treat myocardial infarction by APBSCT.