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慢性心筋不全に対する心内骨髄細胞注射:ランダム化制御試験
Jan van Ramshorst1, Jeroen J Bax, Saskia L M A Beeres
1Department of Cardiology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands.
JAMA
|May 21, 2009
まとめ
心臓内髄骨髄細胞注射は,慢性心筋不全症の患者で心筋 perfusion と左心室機能をわずかに改善しました. 長期的な結果を評価するためにさらなる研究が必要である.
科学分野:
- 心臓病学 心臓病学
- 再生医学は,再生医療である.
- クリニック・トライアル 臨床試験
背景:
- 以前の研究によると,骨髄細胞注射は,慢性心筋不全において心筋 perfusion と左心室 (LV) 機能を強化することが示唆されています.
- 慢性心筋不全症の患者は,しばしば重度の症状を呈しており,従来のリバスカライゼーションには適していません.
研究 の 目的:
- 慢性心筋不全症の患者における心筋 perfusion と LV 機能に対する心筋内骨髄細胞注射の影響を評価する.
主な方法:
- ランダム化され,二重盲検され,プラセボ対照試験で,慢性心筋動脈不全の患者50人が参加しました.
- 患者は,骨髄由来の自主単核細胞またはプラセボを心内注射で受けた.
- プライマリアウトカムは,心筋 perfusion の合計ストレススコアでした; 二次的なアウトカムには,LVエジェクション分数 (LVEF),アンギナクラス,および生活の質が含まれていました.
主要な成果:
- 骨髄細胞注射は,プラセボと比較して,心筋 perfusion (総ストレススコア) の統計的に有意な改善をもたらしました.
- 骨髄細胞群では,LV射出分数 (LVEF) のわずかな増加が観察されました.
- 骨髄細胞を受けた患者は,カナダ心血管学会 (CCS) のアンギナクラスと生活の質のスコアで有意な改善を示しました.
結論:
- 心臓内髄骨髄細胞注射は,慢性心筋不全症の患者のために心筋 perfusion で,控えめで短期的な利益を提供します.
- この研究は,長期的な有効性,死亡率,罹病率の利益に関するさらなる調査の必要性を強調しています.
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