动脉溶栓联合自体骨髓间充质干细胞治疗股骨头坏死  

Treatment for femoral head necrosis by combining arterial thrombolysis with marrow mesenchymal stem cells

作　　者：史跃[1] 王安明[1] 陈启忠[2] 朱丽丽[1] 刘军权[3] 丁凯[4] 高从敬[1] 

机构地区：[1]解放军97医院医学影像科,江苏徐州221004 [2]解放军97医院急诊科,江苏徐州221004 [3]解放军97医院实验科,江苏徐州221004 [4]解放军97医院血液科,江苏徐州221004

出　　处：《东南国防医药》2010年第1期27-29,共3页Military Medical Journal of Southeast China

摘　　要：目的探讨经动脉溶栓联合自体骨髓间充质干细胞(MSC)灌注介入治疗股骨头缺血性坏死的疗效。方法观察组30例股骨头坏死患者采用seldinger技术,经皮-股动脉穿刺将导管选至股骨头供养动脉,灌注脲激酶40万U,罂栗硷30 mg。然后经旋股内动脉灌注MSC悬液20 ml,MSC数量约为1×107～1×108个。并与同期单纯采用动脉溶栓介入治疗34例作比较。结果观察组股骨头、颈区域狭窄闭塞血管再通,股骨头血管染色区域明显增大,坏死区域逐渐缩小29例。观察组治疗前后关节活动度比较有显著性差异(P<0.01),观察组有效率及临床治愈率均高于对照组。结论经动脉溶栓后灌注自体骨髓间充质干细胞治疗股骨头缺血性坏死可以提高疗效。Objective To explore the effect of arterial interventional thrombolysis combining with injection of autologous bone marrow mesenehymal stem cells （MSC） on the treatment for avascular necrosis of the femoral head （ANFH）. Methods By using the seldinger technique, the catheter was introduced to the supplying artery of the femoral head through the femoral artery on 30 patients of ANFH . Urokinase 4 × 10^5 U and papaverine 30mg were injected into the supplying artery, and 1 × 10^7 - 1 × 10^8 MSC were injected into the femoral circumflex artery. 34 patients of ANFH who received arterial interventional thrombolysis only were used as controls. Results The stenosis and obstruct vessel of the femoral head and neck area in 29 studied patients were revascularized, in which the area of vessel staining of the femoral head increased obviously and necrosis area of the femoral head gradually decreased. The range of motion of the joint was significantly different before and after treatment （P 〈 0.01 ）. The efficiency and cure rate of the study group were higher than that of controlled group. Conclusion It is feasible to treat ANFH by arterial interventional thrombolysis combining with injection of autologous bone marrow mesenchymal stem cells.

关 键 词：股骨头缺血性坏死 骨髓间充质干细胞 动脉灌注 数字减影血管造影 介入治疗 

分 类 号：R681.8[医药卫生—骨科学]