Stem Cells Therapy for Acute Myocardial Infarction: A Literature Review

幹細胞治療於急性心肌梗塞之文獻回顧

邱俊仁(Chiung-Zuan Chiu) ； 徐國基(Kou-Gi Shyu)

《中華民國急救加護醫學會雜誌》 21卷2期 (2010/06) Pp. 63-73

https://doi.org/10.30018/JECCM.201006.0001

摘要

急性心肌梗塞之治療於引用緊急再灌流治療(reperfusion therapy)後已有長足進步。但心肌梗塞後合併心臟衰竭為影響日後病患之一大難題。幹細胞治療用於心肌梗塞後病患經近年來綜合研究分析認為可取代及彌補傳統治療之不足，而達到改善左心室輸出功率，減少左心室直徑，及減少梗塞面積之功能。一般認為，早期（心肌梗塞7天內）及足量（大於10^8細胞）之幹細胞治療可達到最大功效。而幹細胞治療一般認為具有足夠的安全性，因為研究顯示主要心血管副作用及死亡率與對照組相比並無明顯差別。

關鍵字

急性心肌梗塞 ； 心臟衰竭 ； 幹細胞治療

並列摘要

Clinical outcomes of acute, myocardial infarction (AMI) have significantly unproved after the use of reperfusion therapy (thrombolysis, percutaneous coronary intervention, or coronary artery bypass grafting). However, congestive heart failure resulting from ventricular remodeling after AMI continues to be a major problem. Recent literatures review confirms that stem cells (either derived from bone marrow or peripheral blood) can be effectively and safely delivered into infarcted myocardium by intracoronary, intramyocardial, or combinational (intracoronary and intramyocardial) transfer. In meta-analysis of randomized controlled trials, stem cells transferred after AMI can improve left ventricular (LV) ejection fraction, decrease LV volume and diameter, and reduce infarct size. The major factor related to favorable outcomes is the early transfer of a sufficient amount of stem cells (within 7 days after AMI) and with at least ＞10^8 cells. Major adverse cardiovascular events and mortality rates remain unchanged as compared with the control group, which means that stem cells transfer is safe and does not increase further risk.

並列關鍵字

acute myocardial infarction ； congestive heart failure ； stem cell transfer