缺血性心脏病的基因治疗.ppt

缺血性心脏病的基因治疗 南京医科大学第一附属医院 心内科 杨志健 现有治疗 药物治疗 PCI CABG 生物学治疗 基因治疗、细胞成形术 优化现有的治疗 为终末期患者提供新的治疗途径 基因治疗的目的在于修复、替代体内突变、缺失的基因或加强某些被不良抑制基因的功能，或抑制某些不当过强表达基因的功能，以达到使机体异常的功能、代谢得以改善、恢复的目的。 Angiogenesis Status 基因治疗： VEGF-121进行了人下肢缺血性治疗的二期临床试验(863) 血管生成素（Ang）： 稳定新生血管壁 血管口径增大 VEGF165和Ang1基因 促血管生成和抗缺血研究 研究内容 构建Ad5-VEGF165和Ad5-Ang1 联合转染促血管生成作用研究 联合转染抗心肌缺血作用研究 机制探讨 研究结果 腺病毒介导肝细胞生长因子治疗缺血性心脏病(863,973) Ad-HGF Clinical Trial PhaseⅠin China 23 CHD patients, divided into 3 groups by different dose of Ad-HGF 5×109pfu Ad-HGF 1×1010pfu Ad-HGF 2×1010pfu Ad-HGF Low dose group:6 cases Middle dose group:6 cases High dose group:11cases 11 patients only received HGF therapy Safety 2 patients have transient fever(38.0-38.5 0C) within one week after gene therapy，and recovered after 2-3 days All subjects have routine examination of blood, biochemical index, and tumor marker, all of them have no significant change Efficiency Evaluate the efficiency in patients received HGF therapy only Code H-01 Name LYNA Sex Male Age 72 Birth date 1934.03.25 Diagnosis1.Coronary artery disease；2.unstable angina Angina grading (Canada）Ⅲ Angiography：1.LAD proximal segment 90% stenosis；2.LCX proximal middle segment 80%，middle segment:total occluded ；3.RCA mild stenosis LAD、LCX with HGF After 5 weeks Angino grading（Canada）Ⅱ ECT ：after treatment, the perfusion of inferior wall improved, LV diameter diminished Prepost Prepost Prepost Prepost M-02 Name:SXBA Sex Female Name 74 Birth Date 1932.08.14 Diagnosis 1.CHD；2. unstable angina Angina grading（Canada）Ⅲ Angiography 1.LAD proximal segment total occluded ；2.LCX middle and distal segment 90% stenosis；3.RCA proximal segment 70% stenosis LAD、LCX with HGF After 5 weeks Angina grading (Canada)Ⅱ ECT：anterior and posterior wall perfusion improved M-03 Name GSBI Sex male Age 52 Birth date 1954.04.25 Diagnosis 1. CHD；2. Stable angina Angina grading（Canada）Ⅱ Angiography 1.LAD pr