自体骨髓间充质干细胞移植改善重度眼表损伤临床观察  

Autologous transplantation of bone marrow mesenchymal stem cells to improve ocular surface in severely damaged cases

作　　者：陈洁[1] 潘志强[2] 骆非[2] 接英[2] 彭秀军[1] 

机构地区：[1]海军总医院眼科,北京100048 [2]首都医科大学同仁医院眼科中心,100730

出　　处：《中国实用眼科杂志》2011年第11期1150-1154,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的评价自体骨髓间充质干细胞在严重眼表损伤移植后的治疗效果。方法选取了化学烧伤4例，Stevens—Johnson综合征2例。骨髓间充质干细胞取白患者，细胞培养14d后，经细胞检测鉴定为骨髓间充质干细胞，将细胞种植在羊膜表面，细胞扩增融合达90％后使用。手术切除表面结膜化组织达角膜缘外3mm，将羊膜上培养的自体骨髓问充质干细胞移植到角膜及角膜缘表面，术后予抗生素、激素、人工泪液点眼治疗；病人定期随访，进行裂隙灯显微镜及印迹细胞学检查。结果6例患眼均覆盖了含有白体骨髓间充质干细胞的羊膜片，术后l周角膜上皮完整。3例患者视力有改善，2例患者视力保持术前水平，1例患者视力下降。术后所有患者眼表面光滑程度有所改善，但新生血管没有明显减少。术后12周印迹细胞学检查结果，1例患者角膜表面可检测到上皮样细胞及杯状细胞。结论自体骨髓问充质干细胞移植可以改善眼表条件，有潜在应用于治疗角膜缘功能障碍的价值。Objective To evaluate the effect of （BMSC） in treating severely damaged ocular surface. autologous bone marrow mesenchymal stem ceils Methods Four cases of corneal chemical burn and two cases of Stenven-Johnson Syndrome were enrolled in this study. The BMSCs were obtained and cultured in vitro. The cells were harvested after 14 days and confirmed to be BMSCs. Then the cells were placed on an amniotic membrane （AM） and expanded until 90% confluence formation be- fore using. After the abnormal conjunctival and corneal tissues were removed from the cornea, the AM coated autologous BMSCs were transplanted onto the corneal surface. After surgery, antibiotics, steroid and lubricant eye drops were used and patients were examined by slit-lamp and impression cytology. Results In all the six treated eyes, the entire corneal epithelium was intact one week after surgery. The visual acuity improved in three eyes, two eyes kept at the same level and decreased in one eye. The ocular surface was smooth, but the new blood vessels didn＇t show significant reduction. After twelve weeks, the epithelial cells phenotype and goblet cells appeared on corneal surface. Conclusions Autologous BMSCs can improve ocular surface condition in severely damaged patients, which show potential use for treating limbal deficiency.

关 键 词：自体骨髓间充质干细胞 羊膜 移植 角膜缘功能障碍 

分 类 号：R684[医药卫生—骨科学]