| Background:However the traditional treatment methods for coronary heart disease(CHD)can temporarily relieve pain and improve the quality of life,they can't restore and regenerate the myocardial tissue.Stem cells have been reported to possess the potential functions of tissue regeneration and multiplex differentiation characteristics and they provide a new opportunity for the CHD treatment.Because of the unique advantages of umbilical cord mesenchymal stem cells(UC-MSCs)including easy separation,no immune rejection reaction,no ethical dilemmas but remarkable immunomodulatory effects,UC-MSCs have been considered as one of the most ideal candidate seeds for the CHD treatment in most recent years.Objective: To investigate the clinical efficacy of 3-years following up of UC-MSCs transplantation in patients with CHD.Methods: During the period of January 2013 to June 2016,8 patients with coronary heart disease were admitted to the First Hospital of Hebei Medical University and randomly divided into experimental group and control group with 4 patients in each group.Patients in the experimental group received both conventional treatment and intravenous infusion of UC-MSCs,and patients in the control group only received conventional treatment.After 3 years-followed up,cardiac function indexes,biochemical index and ST segment changes of electrocardiogram leads were evaluated in two groups.Results: Patients in each group were alive after 3 years.Compared with control group,the LVEF and LVFS in UC-MSCs group displayed an increasing trend.(LVEF: 55.75±10.69 vs 52.25±12.95;LVFS: 30.00±6.78 vs 27.50±7.77,P>0.05).However,the changes of LVEF and LVFS in UC-MSCs group indicated an important statistical improvement comparing with control group(LVEF: 6.50±3.42 vs-2.25±4.57;LVFS: 4.25±2.22 vs 1.5±2.87,P<0.05).There was no significant improvement in NYHA.Furthermore,we compared the biochemical indicators and ST segment changes of electrocardiogram leads which revealed no significant statistical difference between them(P>0.05).Conclusion:Part of CHD patients,echocardiographic measurements after treatment with UC-MSCs showed an improved trendence than the control group,including that the changing values of LVEF and LVFS were significantly higher than the control group.But the cardiac function classification,biochemical indicators and electrocardiograph ST segments showed no statistically significant difference between them.Therefore,the significantly effectiveness of UC-MSCs treatment needs further deep research,and the risks and benefits of this method also deserves further study.Objective: to investigate the effects of human umbilical cord mesenchymal stem cells and astragaloside on cardiac functional repairation after myocardial infarction in SD rats,and to explore the cardiac function of human umbilical cord mesenchymal stem cells in combination with astragaloside treatment of SD rats after myocardial infarction.Methods: 1.Choosing 20 male Sprague-Dawley(SD)rats and randomly divided into 5 groups: 4 rats in control group(Sham),4 rats in the group of myocardial infarction(MI),4 rats in the group of myocardial infarction with the treatment of human umbilical cord mesenchymal stem cells(MI + h UC-MSCs group),4 rats in the group of myocardial infarction with the treatment of astragaloside(MI + AST goup),4 rats in the group of myocardial infarction with the treatment of umbilical cord mesenchymal stem cells and astragaloside(MI + h UC-MSCs + AST group).The model of myocardial infarction was established by means of thoracotomy and ligation of the left anterior descending branch of the heart.The rats in the pure MI group were only treated with thoracotomy,the rats in the Sham group were only treated with thoracotomy but not treated with ligation.All rats needed to be injected with h UC-MSCs 2 days later after the operation of myocardial infarction.The rats requiring AST intervention gavaged astragaloside bagan at the day of myocardial infarction operation,and continued for 7 days.Echocardiograph and relevant datas were collected in all groups 4 weeks after thoracotomy and myocardial infarction.Results :1.Compared with Sham group,postoperative left ventricular ejection fraction and left ventricular short-axis shortening rate in MI group decreased significantly and had statistical significance(P<0.05),indicating a significant decline in cardiac function.The left ventricular end-systolic diameter,the left ventricular end-systolic diameter,and the left ventricular end-systolic volume,the left ventricular end-diastolic volume were increased in the MI group compared with Sham group,suggesting that the remodeling of the left ventricle was obvious.2.Comparisons were made between MI+UC-MSCs+AST group and MI group,the left ventricular ejection fraction and left ventricular fractional shortening rate were statistically difference(P<0.05),and the contract of left ventricular end-diastolic diameter,end-systolic diameter,the end of the left ventricular end-diastolic volume and left ventricular end-systolic volume were significantly reduced,with statistically significant results(P< 0.05).Compared with the MI group,the MI+AST group and the MI+ h UC-MSCs group also showed an improvement trend in some cardiac functions.3.The left ventricular ejection fraction and left ventricular fractional shortening rate of SD rats treated with umbilical cord mesenchymal stem cells after myocardial infarction were significantly higher than those of SD rats treated with astragaloside after myocardial infarction,with statistically significant results(P<0.05).Compared with umbilical cord mesenchymal stem cells injected into the posterior cail vein of myocardial infarction,umbilical cord mesenchymal stem cells combined with astragaloside had a more significant effect on improving left ventricular remodeling after myocardial infarction.The left ventricular end-systolic diameter was statistical significance(P<0.05).Left ventricular end-diastolic volume and end-systolic volume were decreased;The results of left ventricular end-diastolic volume were statistically significant(P<0.05)Conclusions: 1.Transplantation of human umbilical cord mesenchymal stem cells into the tail vein and astragaloside gavaged of SD rats after myocardial infarction can improve their cardiac systolic function to a certain extent;2.Umbilical cord mesenchymal stem cells combined with astragaloside were more effective in improving left ventricular remodeling in SD rats after myocardial infarction than astragaloside or human umbilical cord mesenchymal stem cells alone.3.Umbilical cord mesenchymal stem cells were more effective in improving left ventricular ejection fraction and left ventricular shortening rate than astragaloside. |
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