两种不同途径移植自体骨髓间充质干细胞治疗早期脊髓损伤疗效观察  

The therapeutic effects of two different ways of autologons bone marrow mesenchymal stem cells transplantation for treating early spinal cord injury

作　　者：肖以磊 朱建新 李忠民 周杰 庞月玖[3] 耿凤阳 郭传军 张树葆 张学广 张志逖 

机构地区：[1]山东省聊城市脑科医院神经外科,252000 [2]山东省聊城市职业技术学院护理学院 [3]山东省立医院神经内科

出　　处：《中国医师进修杂志》2012年第14期24-28,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的观察比较蛛网膜下隙注射和静脉注射两种途径移植自体骨髓间充质干细胞治疗早期脊髓损伤的近期有效性和安全性。方法2006年11月至2010年3月收治早期脊髓损伤患者96例，采用随机数字表法分为三组，其中蛛网膜下隙移植组38例患者通过蛛网膜下隙注射方式行自体骨髓间充质干细胞移植，静脉移植组32例患者通过静脉注射方式行自体骨髓间充质干细胞移植，对照组26例仅给予常规治疗。分别于治疗前，治疗后1、3、6个月采用美国脊髓损伤协会（ASIA）制定的评分标准对三组患者运动、感觉功能进行评定。同期随访血常规、凝血功能、生化全项、肿瘤标记物。结果治疗后1个月，三组患者运动、感觉功能都有不同程度恢复，感觉功能恢复更为明显，各组间比较差异均无统计学意义（P〉0．05）。治疗后3个月，三组患者运动功能评分均有所提高，各组间比较差异均无统计学意义（P〉0．05）。蛛网膜下隙移植组和静脉移植组患者感觉功能评分[分别为（130．9±41．6）、（131．2±22．7）分]均显著提高，与同期对照组[（109．3±36．4）分]比较差异有统计学意义（P〈0．05），但蛛网膜下隙移植组和静脉移植组比较差异无统计学意义（P〉0．05）。治疗后6个月，对照组患者运动、感觉功能评分均未出现明显提高；蛛网膜下隙移植组和静脉移植组患者仍有明显恢复，与同期对照组比较差异有统计学意义（P〈0．05）；蛛网膜下隙移植组感觉功能评分[（151．6±46．9）分]较同期静脉移植组[（134．6±40．7）分]有显著提高（P〈O．05）。随访各项检查结果中均未出现明显异常。结论蛛网膜下隙注射和静脉注射两种途径进行自体骨髓间充质干细胞移植治疗早期脊髓损伤均安全，近期疗效确切，但蛛网膜下隙注射途径优于静脉注射途径，但远期疗效及安全性�Objective To compare the short-term efficacy and safety of autologous bone marrow mesenchymal stem ceils transplantation on patients with early spinal cord injury by subaraehnoid injection and by intravenous injection. Methods Ninety-six patients with early spinal cord injury were hospitalized and treated from November 2006 to March 2010. Thirty-eight cases （subarachnoid transplantation group） got transplantation by subarachnoid injection, 32 cases （intravenous transplantation group） got transplantation by intravenous injection, 26 cases （control group） were hospitalized in the same period but not transplanted. The motor and sensory functions of all three groups were evaluated according to the score standard developed by American Spinal Injury Association （ASIA） before treatment and at the first,the third,the sixth month after treatment. Meanwhile, routine blood test, coagulation, biochemical items and tumor markers were also examined in follow-up. Results The motor and sensory function of three groups had different degree of recovery at the first month after treatment ,and sensory function recovered much significantly,but the comparison among three groups had no statistical significance. The scores of motor function increased in three groups at the third month after treatment, but still had no statistical significance （P 〉 0.05 ）. The scores of sensory function of subarachnoid transplantation group [（130.9 ±41.6） scores] and intravenous transplantation group [ （ 131.2 ± 22.7） scores ] increased obviously, and had significant difference compared with control group [ （ 109.3 ± 36.4） scores ] （P 〈 0.05）, but there were no significant difference between subaraehnoid transplantation group and intravenous transplantation group （P 〉 0.05）. The scores of sensory and motor function of control group didn＇t increase obviously at the sixth month after treatment ,while the scores of subarachnoid transplantation group and intravenous transplantation group gradually improved a

关 键 词：间质干细胞 脊髓损伤 移植 自体 

分 类 号：R651.2[医药卫生—外科学]