脐带间充质干细胞治疗难治性原发性血小板减少性紫癜近期疗效  

Latter efficacy evaluation on the treatment of refractory idiopathic thrombocytopenic purpura with human umbilical cord mesenchymal stem cells

作　　者：徐淑芬[1] 白海[1] 王存邦[1] 潘耀柱[1] 陈燕[1] 周树娥[1] 

机构地区：[1]甘肃省兰州市兰州军区兰州总医院血液科,甘肃兰州730050

出　　处：《中国现代医学杂志》2014年第33期35-38,共4页China Journal of Modern Medicine

摘　　要：目的观察人脐带间充质干细胞（h UC-MSCs）治疗难治性原发性血小板减少性紫癜（ITP）近期疗效及不良反应。方法分析12例2012年1月-2012年12月该院住院确诊为难治性ITP患者的临床资料,所有患者均给予人脐带间充质干细胞输注治疗,每次静脉输注（3～5）×10^7个细胞,1次为1个疗程,每周1次,共2～3疗程。结果本组患者的起效时间为1～4周,12例患者中4例获完全缓解（CR）,CR率为33.3%,4例获部分缓解（PR）,PR率为33.3%,总有效率（CR＋PR）为66.6%（8/12）,2例血小板抗体正常患者及2例脾切除患者无效。T细胞亚群的异常表达可能参与了ITP的免疫发病机制,h UC-MSCs输注对T细胞亚群有调节作用,血小板相关抗体及巨核细胞数与疗效有一定相关性。结论人脐带间充质干细胞治疗难治性ITP近期疗效好,副作用轻微,可在临床推广使用。[ Objective ] To observe the clinical effect and side effects of human umbilical cord mesenchymal stem cells （hUC-.MSCs） in the treatment of refractory idiopathic thrombocytopenic purpura （ITP）. [ Methods ] The clinical data of 12 patients with refractory ITP who were followed up in our hospital from January 2012 to December 2012 were analyzed. A total of 12 patients were given hUC-MSCs by intravenous injection at a dose of （3-5）×10^7 cell in a course, 2-3 cycles. [ Results ] The majority of responses took place in the 1-4 week, 4 complete response （CR） and 4 partial response （PR） were observed, the total response rate （CR＋PR） was 66.6% （8/12） after treatment with hUC- MSCs, two normal platelet associated IgG （PAIgG） and two splenectomized patients had no response. The abnormal expression of T cell subsets may involve in ITP immunopatbogenesis, the hUC-MSCs intravenous injection has mod- ulatory effects on T cell subsets in case with ITP, there was a close relationship and certain correlation among the levels of PAIgG and the count of megakaryocyte. [ Conclusions ] Our results show that the hUC-MSCs intravenous injection induces a clinically significant response in patients with refractory ITP, it induced rapid response, with lit- tle associated toxicity, but it have a relapse tendency, hUC-MSCs should be applied to the refractory ITP treatment.

关 键 词：人脐带间充质干细胞 原发性血小板减少性紫癜 治疗效果 

分 类 号：R329.2[医药卫生—人体解剖和组织胚胎学] R55[医药卫生—基础医学]