脐血单个核细胞对缺血性脑卒中的临床干预  

Intravenous infusion of umbilical cord blood mononuclear cells in patients with ischemic stroke

作　　者：满勇[1] 王飞[1] 姬汴生[2] 李建斌[3] 张大焕 马冀[1] 周璐[1] 李青[1] 丁金萍[1] 王晓鸣[1] 单泓[3] 李锦山 李新民[1] 李金花 

机构地区：[1]郑州市第二人民医院神经外科,450052 [2]河南大学天然药物与免疫工程重点实验室,开封475004 [3]河南省红十字血液中心,郑州450012 [4]郑州大桥医院产科,450053

出　　处：《中华细胞与干细胞杂志（电子版）》2017年第6期339-344,共6页Chinese Journal of Cell and Stem Cell（Electronic Edition）

基　　金：郑州市科技局领军人才项目(131PLJRC681)

摘　　要：目的观察多份人脐血单个核细胞(MNC)静脉输注对缺血性脑卒中患者神经功能的改善作用。方法选择2008年4月至2015年5月在郑州市第二人民医院、郑州大桥医院住院和门诊收治的缺血性脑卒中患者76例(参照第四届全国脑血管病学术会议修订的脑卒中诊断标准,并经CT、MRI确诊),按照治疗方案的不同分为脐血MNC组和对照组,急性期对照组采用常规治疗,慢性期对照组采用康复治疗,脐血MNC组在常规治疗或康复治疗的基础上加用脐血MNC手背浅静脉输入,每例输入6次,每次细胞数大于或等于1×10~8个,每次间隔1~7 d。治疗前后神经功能缺损程度(NFD)、患侧肢体运动功能评价Fugl-Meyer(FMA)及日常生活评价(ADL)的比较采用配对t检验,组间比较采用独立t检验。结果脐血MNC组急性期治疗后NFD评分(11.50±2.58)明显低于急性期脐血MNC组治疗前(26.83±5.55,t=6.186,P<0.01)和对照组治疗后(24.33±5.16,t=5.442,P<0.01),脐血MNC组慢性期治疗后NFD评分(12.41±3.83)明显低于慢性期脐血MNC组治疗前(23.10±4.54,t=10.184,P=0.000)和对照组治疗后(23.09±3.94,t=11.012,P<0.01);脐血MNC组急性期治疗后Fuel-Meyer(上肢22.16±2.63,下肢32.00±5.32)明显低于急性期脐血MNC组治疗前(上肢11.66±2.94,t=-6.505,P<0.01;下肢12.66±3.01,t=-7.5386,P<0.01)和对照组治疗后(上肢15.00±3.63,t=-3.871,P=0.003;下肢16.83±4.91,t=-5.048,P<0.01),脐血MNC组慢性期治疗后Fuel-Meyer(上肢15.10±2.08,下肢15.03±1.86)明显低于慢性期脐血MNC组治疗前(上肢8.81±2.19,t=-11.748,P<0.01;下肢8.84±2.30,t=-12.619,P<0.01)和对照组治疗后(上肢9.16±2.60,t=-10.069,P<0.01;下肢9.69±2.98,t=-11.441,P<0.01);脐血MNC组急性期治疗后Barthel指数评分(65.83±7.35)明显低于急性期脐血MNC组治疗前(21.66±5.57,t=-11.916,P<0.01)和对照组治疗后(42.50±5.20,t=-6.387,P<0.01),脐血MNC组慢性期治疗后Barthel指数评分(63.40±9.19)明显低于慢性期脐血MNC组治疗前(25.20±3.8Objective To study the effect of multiple human umbilical cord blood mononuclear cells （HCMNC） on the neurological and motor function as well as living activities in patients with ischemic stroke via intravenous transplantation. Methods According with the Fourth National Conference on cerebrovascular disease, 76 cases of ischemic stroke patients confirmed by CT and MRI, and in the second people＇s Hospital of Zhengzhou, Zhengzhou bridge hospital and outpatient from April 2008 to May 2015 were collected and divided into treatment group and controls according to the clinical trial protocol. The control groups in the acute and chronic stage were treated routinely and treated with rehabilitation therapy, respectively. On the basis of conventional therapy or rehabilitation therapy, the treatment group was treated with HCMNC of umbilical cord blood which were intravenously infused into the superficial vein of the back of the hand. Each patient received averagely 6 copies （cell number over 1× 10 5/each）, each time interval lasted 1 to 7 days, average 4 days. The comparison for the difference of the NFD, FMA and ADL before and after therapy was performed using pared t test and the comparison between groups was made using independent-samples t test. Results In acute stage, the NFD scores in HCMNC group after treatment with HCMNC （12.41± 3.83） were significantly lower than those in before treatment group （26.83± 5.55, t = 6.186, P 〈 0.01） and control group （24.33±5.16, t = 5.442, P 〈 0.01）; In restoration stage, the NFD scores in HCMNC group after treatment with HCMNC （12.41±3.83） were significantly lower than those in before treatment group （23.1 ±4.54, t = 10.184, P 〈 0.01） and control group （23.09 ± 3.94, t = 11.012, P 〈 0.01）; In acute stage, Fuel-Meyer in HCMNC group after treatment with HCMNC （upper limbs 22.16±2.63, lower limbs 32±5.32） were significantly lower than those in before treatment group （upper limbs 11.66 ±2.94, t = -6.505, P 〈 0.01 ;lower limbs 1

关 键 词：脐血单个核细胞 静脉输注 缺血性脑卒中 

分 类 号：R743.3[医药卫生—神经病学与精神病学]