自体干细胞原位移植治疗青中年缺血性脑卒中  

Autologous stem cell orthotopic transplantation in treatment of young middle-age patients with ischemic stroke

作　　者：陈育华[1] 许力[1] 陈奇鸣[1] 陈守康[1] 许文芳[1] 屈洪党[1] 钱伟东[1] 韦道祥[1] 刘晓林[1] 

机构地区：[1]蚌埠医学院第一附属医院神经内科,安徽省蚌埠市233000

出　　处：《中国组织工程研究与临床康复》2011年第1期59-62,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：蚌埠医学院一附院院级新技术项目(2009D52)~~

摘　　要：背景:如能提高患者内源性干细胞水平,使之归巢到损伤部位,从而增强损伤后自我修复能力,这样既符合机体自身损伤的反应性修复机制,又可以避免异基因移植引起的免疫排斥反应。目的:通过观察粒细胞集落刺激因子动员自体干细胞原位移植治疗青中年急性缺血性脑卒中患者功能恢复及梗死面积变化,探讨原位移植治疗青中年缺血性脑卒中的安全性和有效性。方法:40例青中年大脑中动脉区急性缺血性脑卒中患者,随机分为原位移植组20例和对照组20例。原位移植组在发病7～10d内开始给予粒细胞集落刺激因子15μg/kg皮下注射连用5d,动员自体干细胞原位移植,其他治疗同对照组;对照组予以常规治疗。取发病10d内及发病3个月后CT片进行阿尔伯特CT评分(ASPCTS)及国立卫生研究院卒中评分(NIHSS)。结果与结论:治疗过程中患者未出现严重不良反应。随访3个月,原位移植组ASPCTS评分明显增加,NIHSS评分减小明显,与对照组比较差异有显著性意义(P<0.05)。结果表明粒细胞集落刺激因子动员自体干细胞原位移植治疗青中年急性脑梗死安全可行,能显著减小脑梗死体积和促进神经功能恢复。BACKGROUND：If endogenous stem cells levels were elevated in patients,and stem cells homing to a damaged site,and then self-repair ability was enhanced,which is accorded with reactive repair mechanism of self-damage,and can avoid immunologic rejection induced by allotransplantation. OBJECTIVE：To investigate safety and availability on autologous stem cell stimulated by granulocyte colony-stimulating factor （G-CSF） orthotopic transplantation in treatment of young middle-age acute ischemic stroke by observing functional recovery and infarct area changes. METHODS：A total of 40 cases of young middle-age acute cerebral infarction （middle cerebral artery territory） patients were divided into two groups randomly. In orthotopic transplantation group,20 patients received subcutaneous G-CSF （15 μg/kg per day） injections for 5 days within 7-10 days following onset. The rest treatment was identical to the control group. In control group,patients were given conventional therapy of infarction. Before 10 days and 3 months after onset,National Institutes of Health Stroke Scale （NIHSS） and the Alberta stroke program CT score （ASPCTS） were performed. RESULTS AND CONCLUSION：No patients developed severe adverse reaction during the treatment. NIHSS of treatment group after 3 months was lower and ASPCTS was higher significantly than the control group （P 0.05）. Results indicate that it was safe and effective for young middle-age patients with acute cerebral infarction to be treated by autologous stem cells stimulated by granulocyte colony-stimulating factor orthotopic transplantation. The treatment can decrease infarct size and improve the recovery of neurological function.

关 键 词：脑梗死 粒细胞集落刺激因子 自体干细胞 原位移植 神经功能 

分 类 号：R394.2[医药卫生—医学遗传学]