自体骨髓间充质神经干细胞移植治疗帕金森病的疗效观察  

Transplanting autologous mesenchymai stem cells in the treatment of Parkinson＇s disease

作　　者：刘定华[1] 顾鲁军 韩伯军[1] 王庆广[1] 洪珊珊[1] 高恒 万美荣[4] 叶英[5] 

机构地区：[1]东南大学医学院附属江阴医院神经内科,江阴214400 [2]江阴市第五人民医院 [3]江苏省干细胞与生物医用材料重点实验室江阴临床干细胞研究室 [4]徐州医学院附院中心实验室 [5]江苏省麻醉学重点实验室

出　　处：《中华物理医学与康复杂志》2016年第3期194-198,共5页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的探讨自体骨髓间充质神经干细胞移植治疗帕金森病的疗效及安全性。方法选取2010年12月至2013年12月期间在我院治疗的帕金森病患者42例，采用随机数字表法将其分为移植组及对照组，每组21例。2组患者均给予常规药物治疗及康复干预，移植组在此基础上辅以自体骨髓间充质神经干细胞移植治疗，首先抽取患者骨髓并分离、培养骨髓间充质神经干细胞，待培养细胞达到治疗要求后进行神经十细胞移植，共进行4次细胞移植治疗，每次细胞移植间隔5～10d。于治疗前、治疗4周、治疗后3个月时分别采用帕金森病综合评分量表（UPDRS）对2组患者进行疗效评定；同时观察上述时间点2组患者外周血液中血管内皮生长因子（VEGF）及脑脊液中白细胞介素-10（IL-10）、肿瘤坏死因子-α（TNF—α）表达情况。结果经治疗4周及治疗后3个月时，发现移植组及对照组患者UPDRS评分[治疗4周时分别为（41．26±17．92）分、（47．13±18．35）分，治疗后3个月时分别为（33．67±17．77）分、（39．03±16．50）分]均较治疗前有一定程度下降，并且上述时间点移植组患者UPDRS评分均显著低于对照组水平，组间差异均具有统计学意义（P〈0．05）；在整个治疗过程中未观察到移植组患者出现严重不良反应。另外移植组患者在治疗4周及治疗后3个月时，其外周血液中VEGF及脑脊液中IL—10表达均较治疗前明显增强，脑脊液中TNF—α表达则较治疗前明显降低。结论自体骨髓间充质神经干细胞移植可促进帕金森病患者神经功能恢复，且治疗过程中未发生明显不良反应，安全性较好，该疗法值得临床进一步研究、推广。Objective To explore the curative effect and safety of transplanting autologous mesenchymal stein cells to patients with Parkinson＇s disease. Methods Forty-two patients with Parkinson＇s disease were selected and randomly divided into a control group and a research group, each of 21. Both groups were given routine treatment and rehabilitation, but the research group was additionally provided with autologous bone marrow mesenchymal stem cell transplantation. Bone marrow mesenchymal stem cells were isolated from the patients, cultured and transplanted back into the patients totally 4 times at intervals of 5 to 10 days. Before the treatment and 4 weeks and 3 months later, the clinical functioning of both groups was evaluated using the Unified Parkinson＇s Disease Rating Scale （ UPDRS）. Four weeks and 3 months after the treatment, the peripheral blood expression of vascular endothelial growth factor （VEGF） , the expression of interleukin 10 （IL-10） and the expression of CSF tumor necrosis factor alpha （TNF-α） in eerebrospinal fluid were compared between the 2 groups. Results The average UPDRS score of the research group decreased fi＇om （41.26±17.92） at four weeks to （33.67±17.77） at 3 months after the treatment, both significantly lower than before the treatment, and significantly lower than the scores of the control group at the same time points [ （47.13 ± 18.35 ） and （39.03± 16.50） [ During the treatment, no severe adverse reactions were observed among the research group. Moreover, after the treatment the blood expression of VEGF and the expression of IL-10 in eerebrospinal fluid were significantly improved in the research group, while that of TNF-α was significantly reduced compared to before the treatment, nclusions The transplantation of autologous mesenehymal stem cells can safely promote nerve function in Parkinson＇s disease patients. It is worth applying in clinical practice.

关 键 词：骨髓间充质神经干细胞 帕金森病 自体移植 

分 类 号：R742.5[医药卫生—神经病学与精神病学]