脐带间充质干细胞移植治疗系统性红斑狼疮的临床分析  

Clinical analysis of umbilical cord derived mesenchymal stem cells transplantation for patients with systemic lupus erythematosus

作　　者：王丹丹[1] 张华勇[1] 冯学兵[1] 华冰珠[1] 刘布骏[1] 王红[1] 叶圣勤 胡祥 曾小峰[3] 侯亚义[4] 孙凌云[1] 

机构地区：[1]南京大学医学院附属鼓楼医院风湿免疫科,210008 [2]江苏省干细胞中心 [3]中国医学科学院北京协和医院风湿免疫科 [4]南京大学医学院免疫学研究室

出　　处：《中华风湿病学杂志》2010年第2期76-79,共4页Chinese Journal of Rheumatology

基　　金：国家自然科学基金（30972736）;“十一五”国家科技支撑计划（2008BA159B02）;江苏省自然科学基金（BK2009034）;江苏省科技成果转化专项资金（BA2009124）;江苏省六大高峰人才基金;江苏省科教兴卫工程项目（RC2007004）

摘　　要：目的探讨脐带间充质干细胞（UC—MSCs）移植治疗重症难治性系统性红斑狼疮（SLE）的疗效及安全性。方法UC—MSCs移植治疗12例SLE患者，评价患者移植前后临床表现和实验室检查指标的变化。结果UC～MSCs移植后，12例SLE患者随访1～26个月。移植后1个月SLE疾病活动指数（SLEDAI）由（18±4）分降低为（10＋4）分（12例，P〈0．01），3个月时持续降为（7±4）分（9例）。UC—MSCs移植后1个月尿蛋白定量（24h）由（3359±1248）mg降低为（2103_＋749）mg（9例，P〈0．01），移植后3个月[（1427±616）mg与（3342±1333）mg，8例，P〈0．01]，2例患者随访至26个月尿蛋白持续下降。5例肾功能不全者血清肌酐由移植前（416±250）μmol／L降至移植后1个月（264±119）μmol／L（P〈0．05）；移植后3个月降至（226±103）μmol／L，与移植前比差异有统计学意义（P〈0．05）。10例低蛋白血症患者移植后1个月血清白蛋白显著上升[（24±4）g／L与（29±3）g／L，P=0．01]，3个月上升至（30±4）g／L。4例患者移植后血小板显著上升，3例患者移植后血清补体C3升高。所有患者均无移植相关并发症。结论UC—MSCs移植治疗重症SLE安全有效，长期疗效需进一步随访观察。Objective To explore the clinical efficacy and safety of umbilical cord derived mesenchymal stem cells transplantation （UC-MSCT） for patients with refractory systemic lupus erythematosus （SLE）. Methods Twelve patients with refractory SLE were enrolled in this study. UC-MSCs （1〉 106/kg cell number） were infused intravenously for each patient. The clinical manifestations and laboratory parameters were compared before and after MSCT. Results The twelve patients were followed up for one to twenty-six months after MSCT. The systemic lupus erythematosus disease activity index （SLEDAI） score decreased from 18±4 to 10±4 one month after MSCT （n=12, P〈0.01 ） and then decreased to 7±4 at three month follow-up. Nine patients showed improvement of 24 h protcinuria [（2103±749） mg vs （3359±1248） mg, P〈0.01] one month after MSCT. Further improvement of 24 h proteinnria was observed in eight patients [ （1427±616） mg vs （3342±1333） mg, P〈0.01 ] at three months post MSCT. Serum creatinine of five patients decreased significantly and ten patients showed an increase of serum albumin. Serum complement C3 increased in three patients and four patients showed obvious amelioration of hematological abnormalities. There was no transplantation related complications for all the patients. Conclusion UC-MSCT is effective and safe for refractory SLE, but further observation is required to evaluate its long term efficacy.

关 键 词：红斑狼疮 系统性 间质干细胞 脐带 移植 

分 类 号：R593.241[医药卫生—内科学] R329.2[医药卫生—临床医学]