自体骨髓基质细胞源神经干细胞移植治疗持续性植物状态  

Autologous bone marrow stromal cells-derived neural stem cell transplantation for treating persistent vegetable state

作　　者：戴宜武[1] 赵春平[1] 罗永春[1] 秦家振[1] 李培建[1] 刘志良[1] 梁春阳[1] 何江弘[1] 沈春森[1] 魏群[1] 

机构地区：[1]解放军北京军区总医院神经外科,北京市100700

出　　处：《中国组织工程研究与临床康复》2008年第29期5649-5652,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：国家自然基金资助项目(30571916);十一五军队计划课题资助项目(06BJ017)~~

摘　　要：背景：前期动物脑干损伤模型实验中观察到骨髓基质细胞源神经干细胞移植后对脑干损伤具有趋化作用。目的：观察骨髓基质细胞源性神经干细胞移植治疗持续性植物状态的可行性及临床效果。设计、时间及地点：自身对照观察实验。于2002—10／2006-12在解放军北京军区总医院神经外科进行。对象：选择持续性植物生存患者45例，年龄3．5～56．0岁，男28例，女17例。方法：患者入院后进行意识指数评分、各项术前常规检查、脑电图、听觉诱发电位检测。取患者自体骨髓20～30mL。分离出骨髓基质细胞，再经过扩增及预分化处理后。将骨髓源神经干细胞制成10^9L^-1浓度。经开颅或立体定向及导管介入将骨髓基质源神经干细胞植入脑内特定区域，靶区为损伤脑区皮质、室管膜下区、纹状体区、丘脑底核或患侧大脑中动脉、椎动脉。主要观察指标：3-4月后检查记录昏迷指数、脑电图、听觉诱发电位，并与治疗前进行对比。结果：全部患者干细胞移植后，生命指征均平稳。5例有短时发热，经对症处理体温恢复正常。3-4个月后随访复查，患者意识（昏迷）指数、脑电图、听觉诱发电位均明显改善。结论：骨髓基质细胞源性神经干细胞移植治疗战创伤性脑损伤及其后遗症，具有促进中枢神经系统组织及功能恢复的作用。BACKGROUND： Previous studies of animal models of brain stem injury have showed that bone marrow stromal cells-derived neural stem cells have a chemotactic effect on brain stem injury following transplantation. OBJECTIVE： To explore the possibility and clinical effect of bone marrow stromal cells-derived neural stem cell transplantation for treating patients with persistent vegetative state. DESIGN, TIME AND SETTING： The self-control study was performed at the Department of Neurosurgery, General Hospital of Beijing Military Area Command of Chinese PLA from October 2002 to December 2006. PARTICIPANTS： Totally 45 patients aged 3.5-56.0 years old, including 28 males and 17 females, with persistent vegetative state were enrolled in this study. METHODS： After admission, patients received Glasgow Coma Scale, preoperative routine examinations, electroencephalogram and auditory evoked potential. 20 to 30 mL of patients＇ bone marrow was collected to harvest bone marrow stromal cells. The cells underwent amplification and pre-differentiation. Bone marrow-derived neural stem cells were collected at a concentration of 10^9 L^-1. Bone marrow-derived neural stem cells were transplanted into particular regions of the brain via open-cranial surgery, stereo-surgery or catheter intervention surgery. Target region included the injured cortex, subventficular region, corpus striatum, discus lentiformis, or middle cerebral artery of affected sides, vertebral artery. MAIN OUTCOME MEASURES： Three to four months after transplantation, Glasgow Coma Scale, electroencephalogram, and auditory evoked potential were examined and compared with that before transplantation. RESULTS： After stem cell transplantation, all patients showed a stable life indication. Five patients developed short-term fever, and their body temperature recovered to normal after expectant treatment. Three to four months after transplantation, coma index, electroencephalogram and auditory evoked potential were significantly improved. CONCLUSION

关 键 词：骨髓基质细胞 神经干细胞 移植 持续性植物状态 

分 类 号：R394.2[医药卫生—医学遗传学]