嗅鞘细胞移植治疗脊髓损伤后顽固性神经性疼痛17例报道  

Preliminary Result of Olfactory Ensheathing Cell Transplantation in Intractable Neuropathic Pain Following Spinal Cord Injury:17 Cases Report

作　　者：陈琳[1,2] 江昭[1] 黄红云[1,2] 张峰[1,2] 刘彦铖[1,2] 郗海涛[1] 王洪美[1,2] 任玉水[1] 周长满[1,3] 

机构地区：[1]北京市虹天济神经科学研究院,北京市100144 [2]北京康复中心神经外科,北京市100144 [3]北京大学基础医学院人体解剖与组织胚胎系,北京市100083

出　　处：《中国康复理论与实践》2010年第2期146-148,共3页Chinese Journal of Rehabilitation Theory and Practice

摘　　要：目的探讨嗅鞘细胞移植对脊髓损伤后顽固性神经性疼痛的治疗效果。方法对细胞学治疗后获得疗效的脊髓损伤合并顽固性神经性疼痛患者的临床资料进行总结。2004年11月～2007年11月间的17例患者,其中男性15例,女性2例,年龄18～68岁,平均40.4岁。受伤6～312个月,平均105.9个月,受伤原因包括车祸、坠落、放射性损伤、机器挤压伤、枪伤、跳水。疼痛持续时间6～309个月,平均102.2个月。嗅球嗅鞘细胞胰蛋白酶消化成单细胞后培养12～14d。细胞移植到损伤段的上下两端。疼痛评价使用国际神经修复学会脊髓损伤日常生活功能评价量表:0分为极度疼痛,止痛药无效;1分为中度疼痛,需用强效止痛药;2分为轻度疼痛,普通止痛药有效;3分为无疼痛。结果随访时间0.5～88个月,平均17.5个月,疼痛平均改善1.2分。结论嗅鞘细胞移植对脊髓损伤后神经性疼痛有一定治疗作用。Objective To explore the feasibility and potential benefit of olfactory ensheathing cell （OEC） intraspinal transplantation in the treatment of intractable chronic neuropathie pain after spinal cord injury （SCI）. Methods 17 patients, 15 male and 2 female, with intractable chronic neuropathic pain after spinal cord injury was treated by OEC implant from November, 2004 to November, 2007. The age ranged from 18 to 68 （mean 40. 4） years. The etiology of cord impairment included car accidents, falls, radiation damage, machine extrusion, gunshot, and diving. The patients suffered severe persistent pain for 6 to 309 （mean 102.2） months, and the time points when cell therapy were administrated in the patients ranged from 6 to 312 （mean 105.9 months） after their injuries. Olfactory bulbs were harvested and trypsinized down to single fetal OECs. They were cultured for 12-14 days before implant. The fetal OECs were transplanted by injection into spinal cord at opposing ends of the injury site. The degree of pain was assessed and compared before operation and long term follow-up according to the International Association of Neurorestoratology Spinal Cord Injury Functional Rating Scale （IANR-SCIFRS）, i. e. , 0 point means extreme pain, uncontrolled; 1 point, severe pain, narcotics required; 2 points, mild pain, ordinary pain killer effective; 3 points, no pain. Results The follow-up and pain reevaluation were performed at 0.5 to 88 months with an average of 17.5 months after cell transplantation. The mean score of pain amelioration is 1.2 points. Conclusion The OEC intraspinal transplantation appears to have a promising role in treatment of intractable chronic neuro pathic pain after SCI.

关 键 词：嗅鞘细胞 神经性疼痛 中枢痛 脊髓损伤 脊髓内移植 神经修复 

分 类 号：R651.2[医药卫生—外科学]