肝细胞生长因子基因修饰间充质干细胞治疗股骨头坏死的探索性研究  

Exploratory Research for Hepatocyte Growth Factor Gene-Modified Mesenchymal Stem Cells on Femoral Head Osteonecrosis

作　　者：楼晓[1] 宫恩年 商丰元 魏成刚 施志超 汪劲松[1] 吴祖泽[1] 郭子宽[2] 

机构地区：[1]军事医学科学院放射与辐射医学研究所 [2]北京66400部队骨病医院

出　　处：《组织工程与重建外科杂志》2009年第2期83-85,107,共4页Journal of Tissue Engineering and Reconstructive Surgery

基　　金：国家高技术研究发展计划(863项目)(2007AA02Z454)

摘　　要：目的探讨肝细胞生长因子基因修饰自体骨髓间充质干细胞治疗股骨头坏死的可行性,并评价其疗效。方法对1例ARCOⅢB股骨头坏死患者,手术过程中局部注射肝细胞生长因子基因修饰的自体骨髓间充质干细胞1×107个,随访观察评价其临床疗效和影像学改变。结果治疗过程顺利,术后无感染及过敏等严重并发症发生。术后随访9个月,患者髋关节疼痛指数较治疗前明显降低,髋关节临床症状Harris评分分值由治疗前的63分提高到治疗后的76分,髋关节活动度Harris评分由治疗前分值2.5分提高至4.2分。CT扫描显示损伤局部出现重建性骨修复,低密度区范围缩小,密度增高。ARCO分期由ⅢB改善至ⅢA。结论肝细胞生长因子基因修饰的自体骨髓间充质干细胞治疗股骨头坏死,安全有效,本次探索为进一步临床研究奠定了基础。Objective To explore the clinical feasibility and therapeutic effect of mesenchymal stem cells modified by hepatoeyte growth factor gene for treating femoral head osteonecrosis. Methods Autologous bone marrow mesenchymal stem cells （MSCs） from one patient with osteoneerosis of the femoral head in a stage of ARCO Ⅲ B were separated and expanded in vivo. Cells were modified by an adenoviral vector carrying human hepatocyte growth factor gene, and total cells of 1.0×10^7 were surgically implanted into the necrotic sites of the affected femoral head. During the nine-month follow-up, the clinical symptoms and imaging change were evaluated. Results No any severe complications that without obvious infection and allergy were observed. After nine months, there was a significant reduction in hip joint pain measured with the WOMAC index. The Harris scores of hip joint were obviously improved, which indicated respectively for clinical symptoms （63 versus 76） and for joint range of motion （2.5 versus 4.2）. Computer Tomography displayed reconstructive repair manifestation, which exhibited as decreased low-intensity region accompanied with new bone formation. The classification of disease severity was improved from stage-Ⅲ B to stage-Ⅲ A, according to the system of the Association Research Circulation Osseous. Conclusion Implantation of autologous MSCs modified by hepatocyte growth factor gene was one of safe and effective treatment for osteoneerosis of the femoral head. Our results here might provide supportive data for further large scale clinical trials.

关 键 词：股骨头坏死 间充质干细胞 肝细胞生长因子 

分 类 号：R683.42[医药卫生—骨科学]