自体骨髓单个核细胞移植治疗重度精神发育迟滞儿童临床观察  被引量:1

Clinical application of autologous bone marrow mononuclear cell transplantation in children with severe mental retardation

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作  者:屈素清[1] 栾佐[1] 李玉佳[1] 杨辉[1] 汪兆艳[1] 杨印祥[1] 

机构地区:[1]海军总医院儿科,北京100048

出  处:《转化医学杂志》2014年第6期343-346,共4页Translational Medicine Journal

摘  要:目的观察自体骨髓单个核细胞(bone marrow mononuelearcell,BM-MNC)移植治疗重度精神发育迟滞(mental retardation,MR)儿童的临床疗效。方法海军总医院儿科自2011年1月2012年3月收治的重度MR患儿40例(年龄2~14岁),骨髓动员后进行BM-MNC分选,分别进行右侧颈动脉穿刺1次及腰椎穿刺3次行BM-MNC移植。每次移植的BM—MNC细胞数为l×10^6/kg。每例患儿对其进行术前6个月及术后6个月自身对照观察,采用家长随访量表,评估2个相同长度时间段内患儿智力、运动的发育状态。同时对移植术后1、3、6个月及1年患儿的发育情况进行追踪随访分析。结果40例中3例失访,余37例完成评估随访。其中,术后有明显进步19例,有效率为51.3%;患儿在术后3d至1个月逐渐出现不同程度的变化,持续至术后6个月后无再进步病例。随访量表进步值术前6个月为(4.69±4.33)分,术后6个月为(16.04±12.54)分,进步幅度术后较术前明显增加,差异有统计学意义(P〈0.01)。结论自体BM-MNC移植安全可靠,能在短时问内改善重度MR患儿智力发育水平,移植及手术不良事件极其轻微。Objective To observe the clinical efficacy of transplantation with autologous bone marrow mononuclear cell( BM-MNC) in treatment of children with severe mental retardation( MR). Methods Fourty children with severe MR( 2 —14 years old),admitted to our hospital from January 2011 to March 2012 were chosen. Autologus mononuclear cells were isolated from mobilized bone marrow,and then were transplanted( 1 × 106/ kg) by right carotid artery puncture( the first time) or lumbar puncture( three times) self-control observation on the mental and motor deve-lopments of these children in the same length of time periods was performed 6 months before and 6 months after the BM-MNC transplantation. Meanwhile,the improvements of each patient were fo-llowed up and analyzed by 1,3,6 months and 1 year after the transplantation. Results Three patients failed to follow-up. The other 37 patients were observed. Significant improvement was noted in 19 patients after the transplantation with an effective rate of 51. 3%. Gradually mental and motor improvements appeared in 19 patients at the 3rd day after the transplantation,and lasted ti1 l the 6th month of transplantation. The average scores of mental improvement were( 4. 69 ± 4. 33) in 6 months before transplantation,and( 16. 04 ± 12. 54) in 6 months after transplantation( P < 0. 01). Conclusion BMMNC transplantation can improve the intellectual development in a short time in children with severe MR. BM-MNC transplantation for severe MR is safe and effective in a short term.

关 键 词:精神发育迟滞 自体骨髓 单个核细胞 移植 儿童 

分 类 号:R748[医药卫生—神经病学与精神病学] R45[医药卫生—临床医学]

 

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