脐带间充质干细胞治疗系统性红斑狼疮的量效关系  

Observation on dose-effect relationship of umbilical cord mesenchymal stem cells treatment for patients with systemic lupus erythematosus

作　　者：杨桂鲜[1] 潘丽萍[1] 陈志琴[1] 周巧艳[1] 汪成孝 

机构地区：[1]昆明医科大学第四附属医院肾内科,云南昆明650021 [2]四川省脐带造血干细胞库,四川成都610021

出　　处：《云南医药》2015年第6期579-584,共6页Medicine and Pharmacy of Yunnan

基　　金：云南省科技厅计划项目(2011FB231)

摘　　要：目的观察脐带间充质干细胞（UC—MSCs）移植治疗难治性系统性红斑狼疮（SLE）的量效关系。方法40例SLE患者随机分为两组，全部患者均接受糖皮质激素和环磷酰胺（CTX）治疗；1组加静脉输注3×10^7个UC—MSCs，2组加静脉输注3×10^7个UC—MSCs2次，观察患者治疗前及治疗后2周、1月、2月、3月、6月、9月、12月、18月的临床表现和实验室检查的变化。结果两组治疗前各观察指标无显著差异（P〉0．05）；两组病例治疗前后WBC，Cr变化不大（P〉0．05），而U—Pro，ANA，Hs—CRP，ESR，Anti—dsDNA阳性率在治疗后显著减低（P〈0．05），血白蛋白、补体升高（P〈0．05），SLEDAI也随之下降（P〈0．05），且U—Pro，ANA，补体3、Anti—dsDNA阳性率在治疗后期2组低于1组（P〈0．05），补体32组高于1组（P〈0．05）；UC—MSC输注时及输注后均未出现移植相关并发症。结论在经典的糖皮质激素加CTX治疗基础上加用UC—MSCs治疗SLE，患者病情明显改善，疗效稳定，持续时间长，且剂量与疗效存在正相关，到目前为止未发现移植相关不良反应，但由于本研究样本量小，观察时间短，其作用途径、长期疗效及安全性有待进一步研究。Objective To observe the dose-effect relationship of umbilical cord mesenchymal stem cells （UC-MSCs） treatment for patients with systemic lupus erythematosus（SLE）. Methods d0 cases of SLE patients were randomly divided into two groups.All of cases were treated with glucocorticoids and cyclophosphamide.3 × 107 UC-MSCs were infused intravenously for each patient of the groupl. The patients of the group2 were infused intravenously of 3× 107 UC-MSCs twice. All were observed of clinical manifestations and laboratory parameters before and 2 weeks, 1 month, 2 months, 3 months, 6 months, 9 months and 12 months after transplantation. Results The indexes before treatment of two groups had no significant difference （P 〉 0.05） . The WBC, Cr of two groups before and after treatment had little change （P 〉 0.05） .U-Pro, ANA, Hs-CRP, ESR, and positive rate of Anti-dsDNA of two groups cases were obviously decreased after treatment （P 〈 0.05）. Blood albumin and complement of two groups elevated after treatment （P 〈 0.05 ）. SLEDAI of two groups decreased significantly after treatment （P 〈 0.05）. U-Pro, ANA, and positive rate of Anti-dsDNA of the groupl were lower than that of the group 2 in later treatment （P 〈 0.05）. The C3 of the group2 was lower than that of the group 1 in later treatment（P 〈 0.05）. There were no trarmplantation related complications for all the patients during treatment and after treatment. Conclusion This study suggests that UC-MSCs is effective and safe for refractory SLE on glucocorticoid and cyclophosphamide therapy basis,and dose and curative effect is positive correlation. Because the sample size is small and a short period of observasion time, further observation is required to evaluate its long term efficacy and side effect.

关 键 词：系统性红斑狼疮 脐带间质干细胞 治疗 

分 类 号：R593.241[医药卫生—内科学]