脂肪干细胞生物活性分泌物防治早产儿脑白质损伤的安全性及早期疗效  

Safety and early curative efficacy of lipocyte bioactive secretion in preventing white matter injury of premature infants

作　　者：曹一翀 刘卫鹏[2] 王凤[2] 王倩[2] 汪兆艳[2] 杨印祥[2] 杨巧芝[3] 张茜[4] 刘芳[5] 刘利军[6] 吕红艳[7] 唐仕芳 张家洁[9] 温志杰 栾佐[1] Cao Yichong;Liu Weipeng;Wang Feng;Wang Qian;Wang Zhaoyan;Yang Yinxiang;Yang Qiaozhi;Zhang Qian;Liu Fang;Liu Lijun;Lyu Hongyan;Tang Shifang;Zhang Jiajie;Wen Zhijie;Luan Zuo(Medical College of Chinese People＇s Liberation Army,Beijing 100853,China;Department of Pediatrics,Chinese People＇s Liberation Army Naval General Hospital,Beijing 100048,Chin;Department of Pediatrics,Liaocheng People＇s Hospital,Liaocheng 252000,Shandong Province,Chin;Department of Neonatology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Pediatrics,Chinese People＇s Liberation Army Bethune International Peace Hospital,Shijiazhuang 050082,China;Department of Neonatology,the Third Staff Hospital of Baogang Group,Baotou 014010,Mongolia Autonomous Region,Chin;Department of Neonatology,Handan Maternal and Child Health Centers,Handan 056001,Hebei Province,Chin;Department of Pediatrics,Daping Hospital Army Medical University,Chongqing 400042,Chin;Neonatal Intensive Care Unit,Henan Province People＇s Hospital,Zhengzhou 450003,Chin;epartment of Neonatology,Wu＇an First People＇s Hospital,Wu＇an 056300,Hebei Province,China)

机构地区：[1]中国人民解放军医学院,北京100853 [2]中国人民解放军海军总医院儿科,北京100048 [3]聊城市人民医院儿科,252000 [4]郑州大学第一附属医院新生儿科,450052 [5]中国人民解放军白求恩国际和平医院儿科,石家庄050082 [6]包钢集团第三职工医院新生儿科,包头014010 [7]邯郸市妇幼保健院新生儿科,056001 [8]陆军军医大学大坪医院儿科,重庆400042 [9]河南省人民医院新生儿重症监护室,郑州450003 [10]武安市第一人民医院新生儿科,河北武安056300

出　　处：《中华实用儿科临床杂志》2018年第19期1503-1507,共5页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的探索脂肪干细胞生物活性分泌物（ASCBS）鞘内注射防治早产儿脑白质损伤（WMI）的安全性和疗效。方法按统一标准在多个医疗中心分3个胎龄组募集63例WMI早产儿，A组：胎龄24～28^＋6周，21例；B组：胎龄29～32^＋6周，20例；C组：胎龄33～36^＋6周，22例。各胎龄组以抛硬币的方法随机分为治疗组及对照组，治疗组连续3 d每天1次腰椎穿刺并鞘内注射ASCBS。于矫正胎龄足月进行新生儿行为神经测定（NBNA），于矫正月龄6个月通过贝利婴幼儿发展量表（BSID）、Peabody运动发育量表第2版（PDMS-2）进行神经发育评估，比较2组间早产儿存活率、NBNA评分、智力发育指数（MDI）、精神运动发育指数（PDI）及PDMS-2发育商。结果63例中包括治疗组31例，对照组32例，所有病例中只有治疗组1例失访。治疗组未发现治疗相关不良反应，所有胎龄组中治疗组及对照组存活率及早产并发症发生率比较差异均无统计学意义（均P〉0.05）。治疗A组的纠正6月龄的粗大运动发育商及总运动发育商高于对照A组，差异均有统计学意义（粗大运动发育商：治疗A组98.330±6.282、对照A组90.330±3.777，P＝0.040；总运动发育商：治疗A组97.330±4.803、对照A组91.000±4.472，P＝0.023），其余结果未发现组间差异。结论ASCBS治疗早产儿WMI具有较好安全性，并能促进24～28周出生胎龄早产儿的运动发育。ObjectiveTo explore the safety and efficacy of intrathecal administration of adipose stem cells derived from bioactive secretome （ASCBS） in treatment of whiter matter injury （WMI） in the preterm infants.MethodsSixty-three cases of WMI were recruited according to the uniform standards from multiple medical centers and they were divided into 3 gestational age （GA） subgroups, which were 21 cases in group A （GA 24-28^＋ 6）, 20 cases in group B （GA 29-32^＋6）, and 22 cases in group C （GA 33-36^＋ 6）. The patients were randomly divided into treatment groups and control groups by tossing coins.The treatment groups received lumbar puncture followed with ASCBS intra-thecal injection once daily for 3 consecutive days.Follow-up study included Neonatal Behavioral Neurological Assessment （NBNA） at term-equivalent age and neurodevelopment at corrected age of 6-month.Neurodevelopment was assessed by using the Bayley Scales of Infant Development and Peabody Developmental Motor Scale.The survival rates, NBNA scores, mental development index （MDI）, psychomotor develop index （PDI）, total motor development quotient, gross motor development quotient and fine motor development among each subgroup were compared.ResultsSixty-three cases were recruited, including 31 in the treatment group and 32 in the control group.Only 1 case in the treatment groups lost in the follow-up.No clinical side effects were found in the treatment groups.There was no significant diffe-rence in the survival rate and complication in the preterms in all subgroups of the treatment group and control group （all P〉0.05）. The gross and total motor development quotient in the treatment group A was higher than that in the control group A（gross motor development quotient： 98.330±6.282 in treatment group A, 90.330±3.777 in control group A, P=0.040; total motor development quotient： 97.330±4.803 in treatment group A, 91.000±4.472 in control group A, P=0.023）. The rest findings showed no significant difference between

关 键 词：干细胞 婴儿 早产 脑白质损伤 脂肪干细胞生物活性分泌物 

分 类 号：R722.6[医药卫生—儿科]