自体骨髓基质干细胞动员联合神经生长因子及综合康复治疗脊髓损伤  

Treatment of injured spinal cord by bone marrow stem cells mobilization in combination with nerve growth factor and comprehensive rehabilitation

作　　者：郭晓鹤[1] 步星耀[1] 闫兆月[1] 马春晓[1] 周伟[1] 周志龙[1] 黄超[1] 钱宝延[2] 

机构地区：[1]河南省人民医院神经外科,郑州450003 [2]河南省人民医院康复科,郑州450003

出　　处：《中华神经医学杂志》2013年第8期833-837,共5页Chinese Journal of Neuromedicine

基　　金：河南省杰出人才计划项目（084200410011）;河南省科技攻关重点项目（0424410054）

摘　　要：目的 探讨自体骨髓基质干细胞（BMSCs）动员联合神经生长因子及综合康复治疗脊髓损伤（SCI）的临床疗效. 方法 选择河南省人民医院神经外科自2006年1月至2011年12月收治的SCI患者72例,根据患者意愿分为2组,对照组32例给予神经生长因子和综合康复治疗,治疗组40例在对照组基础上加用自体BMSCs动员治疗.治疗前后依据美国脊髓损伤学会（ASIA）评分、运动诱发电位（MEP）波幅及潜伏期的变化评价疗效,通过流式细胞术检测外周血细胞CD133＋CD34＋比例,MRI观察SCI治疗前后脊髓的形态学变化,同时观察患者不良反应. 结果 治疗组患者ASIA评分明显升高,MEP潜伏期明显缩短,波幅明显增高,外周血细胞CD133＋ CD34＋比例升高显著,与对照组比较差异均有统计学意义（P＜0.05）.治疗及随访期间均未出现明显不良反应.结论 自体BMSCs动员联合神经生长因子及综合康复治疗可有效促进SCI的修复,显著改善患者的神经功能.Objective To explore the efficacy of autologous bone marrow stem cells mobilization combined with nerve growth factor and comprehensive rehabilitation in patients after spinal cord injury （SCI）.Methods Seventy-two patients with SCI,admitted to our hospital from January 2006 to December 2011,were randomly divided into control group （n=32） and treatment group （n=40）;patients in the control group were given neurotrophic factors and comprehensive rehabilitation therapy while those in the treatment group were given autologous bone marrow stem cells mobilization combined with neurotrophic factors and comprehensive rehabilitation therapy.American Spinal Injury Association Impairment Scale （AISA） scores and changes of amplitude and latency in motor evoked potentials （MEP）were used to evaluate the treatment efficacy.Peripheral blood percentages of CD133＋ and CD34＋ cells was analyzed with flow cytometer.MRI examination was performed to assess the morphology of the injured spinal cord before and after treatment.A4dverse reactions were observed.Results The AISA scores and percentages of CD133＋ and CD34＋ cells in the treatment group increased as compared with those in patients in control group （P〈0.05）.The SEP had been significantly restored with lower amplitude and longer latency in the treatment group as compared with those in patients in control group （P〈0.05）.No patients experienced significant adverse reactions during the treatment.Conclusion Autologous BMSCs mobilization combined with nerve growth factor and comprehensive rehabilitation therapy can effectively promote SCI repair,significantly improve the patients nervous function.

关 键 词：骨髓基质干细胞 脊髓损伤 综合康复 

分 类 号：R651.2[医药卫生—外科学]