关节腔注射人脐带MSCs治疗退行性膝骨关节炎的疗效观察  

CURATIVE EFFECT OF HUMAN UMBILICAL CORD MESENCHYMAL STEM CELLS BY INTRA-ARTICULAR INJECTION FOR DEGENERATIVE KNEE OSTEOARTHRITIS

作　　者：王亚莉[1,2] 金文孝[2] 刘海燕[2] 崔玉华[2] 毛庆聪[2] 费忠英 项春生[1] 

机构地区：[1]浙江大学医学院,杭州310058 [2]武警浙江省总队嘉兴医院生物治疗中心

出　　处：《中国修复重建外科杂志》2016年第12期1472-1477,共6页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨关节腔注射人脐带MSCs治疗退行性膝骨关节炎的安全性及有效性。方法2015年1月-2016年1月，将36例符合选择标准的中重度退行性膝骨关节炎患者纳入研究，随机分为两组（n=18）。其中，细胞治疗组关节腔注射人脐带MSCs细胞悬液2．5-3．0mL，含细胞（2～3）×10^7个，每月1次，2次为1个疗程。对照组关节腔注射玻璃酸钠，每周1次，5次为1个疗程。两组患者性别、年龄、体质量指数、侧别、病程以及治疗前膝关节Lysholm评分、美国西部Ontario与McMaster大学骨关节炎指数评分（WOMAC）以及SF-36量表评分比较，差异均无统计学意义（P〉O．05）。治疗后采用SF-36量表评分、Lysholm评分及WOMAC评分评价临床疗效。结果两组患者均完成1个疗程治疗，均随访6个月。注射后细胞治疗组疼痛、肿胀发生率显著高于对照组（X2=16．200，P=0．000；）（2=11．688，P=0．000），关节腔积液发生率比较差异无统计学意义（X2=2．118，P=0．146）。细胞治疗组患者治疗后1。6个月Lysholm评分以及2～6个月WOMAC评分、SF-36量表评分均优于治疗前（P〈0．05），随访期间患者无膝关节疼痛复发。对照组治疗前后Lysholm评分及SF-36量表评分比较差异均无统计学意义（P〉0．05）；WOMAC评分治疗后1、2、3个月与治疗前比较差异有统计学意义（P〈0．05），治疗后6个月与治疗前比较差异无统计学意义（P〉O．05）；治疗后3个月11例再次出现关节疼痛症状。两组治疗后1、2个月患者膝关节功能评分及SF-36量表评分比较，差异无统计学意义（P〉0．05）；但治疗后3、6个月细胞治疗组各项评分均明显优于对照组（P〈0．05）。结论关节腔注射人脐带MSCs治疗退行性膝骨关节炎可显著改善患者关节功能和生活质量，注射后1个月起效，治疗作用可持续6个月。Objective To investigate the safety and efficacy of human umbilical cord mesenchymal stem cells （MSCs） by intra-articular injection for degenerative knee osteoarthritis. Methods Between January 2015 and January 2016, 36 patients with moderate or severe degenerative knee osteoarthritis were randomly derided into 2 groups （n=18）. Intra-articular injection of 2.5-3.0 mL human umbilical cord MSCs suspension containing （2-3）x107 cells was performed once a month for 2 times as a course of treatment in the cell treatment group; sodium hyaluronate by intra-articular injection was used once a week for 5 times as a course of treatment in the control group. There was no significant difference in gender, age, body mass index, side, stage of osteoarthritis, course of disease, and preoperative Lysholm score of the knee joint, the Western Ontario and McMaster Universities osteoarthritis index （WOMAC）, and SF-36 scale score between 2 groups （P〉0.05）. The clinical efficacy was evaluated by SF-36 scale score, Lysholm score, and WOMAC score. Results All patients of 2 groups received a course of treatment. The patients were followed up for 6 months. After injection, the incidences of pain and swelling in the cell treatment group were significantly higher than those in the control group （X2=16.200, P=0.000; X2=11.688, P=0.000）, but no significant difference was found in the incidence of effusion （X2=2.118, P=0.146）. In the cell treatment group, Lysholm score at 146 months after treatment, WOMAC score and SF-36 scale score at 2-6 months after treatment were significantly better when compared with scores before treatment （P〈0.05）, and no recurrence of knee pain was observed during follow-up. In the control group, there was no significant difference in Lysholm score and SF-36 scale score between pre- and post-treatment （P〉0.05）; there were significant differences in WOMAC score between pre-treatment and at 1, 2, 3 months after treatment （P〈0.05）; at 3 months after treatment, 11 patient

关 键 词：膝关节 退行性骨关节炎 人脐带MSCs 玻璃酸钠 关节腔内注射 

分 类 号：R687.4[医药卫生—骨科学]