Progress of stem cell transplantation in the treatment of dilated cardiomyopathy
高乐 王悦喜
1
当前在心血管疾病中研究较多的干细胞类型
目前，干细胞移植在修复损伤心肌细胞、促进心肌细胞再生、血管重建、改善心脏功能等方面逐渐显现出优势。在心血管疾病研究中，已有多种干细胞运用于临床研究，现大体介绍如下几种干细胞。
1骨髓干细胞
骨髓来源干细胞包括间充质干细胞(marrow mesenchymal stem cells，MSCs)、造血干细胞(hematopoietic stem cells，HSCs)和内皮祖细胞(endothelial progenitor cells，EPCs)等。这类细胞较易获取，可从自体骨髓中直接获得，亦或通过干细胞生成因子/粒细胞集落刺激因子动员后经外周血获取，因此较多用于临床试验中。由于干细胞的全能性，其移植后能促进新生血管形成、减少心肌纤维化、减小左心室舒张末期容积，进而改善心功能、提高生存率[6]。
2胚胎干细胞(embryonic stem cell，ESCs)
3心脏干细胞(cardiac stem cells，CSCs)
心肌细胞具有再生的潜能，研究人员分离出多个干细胞系，例如c-kit＋心脏干细胞(c-kit＋ CSCs)、心肌球来源心脏干细胞(CDCs)、Sca-1＋心脏干细胞(Sca-1＋ CSCs)，皆具有干细胞的多向分化、自我更新等基本特征。CSCs可分化为内皮细胞、平滑肌细胞和心肌细胞，参与梗死心肌损伤后的修复[13,14]。Ellison等[15]通过动物实验证实，在去除CSCs后心脏会失去再生和修复等能力，重新移植CSCs后心脏受损部位得以修复，也通过心肌细胞再生进而改善心功能。
4脂肪干细胞(adipose-derived stem cells，ADSCs)
5骨骼肌干细胞(muscle-derived stem cells，MDSCs)
6诱导多能干细胞(induced pluripotent stem cells，IPSCs)
2
3
干细胞移植途径
4
5
存在问题及展望
参考文献
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