脐带间充质干细胞鞘内注射治疗脊髓损伤的长期临床观察  

Long-Term Clinical O bservation of Umbilical Cord Mesenchymal Stem Cells in Treating Spinal Cord Injury by Intrathecal Injection

作　　者：刘静[1] 韩冬梅[1] 薛梅[1] 阎洪敏[1] 董磊[1] 朱玲[1] 郭子宽[2] 王恒湘[1] LIU Jing;HAN Dongmei;XUE Mei;YAN Hongmin;Dongl Lei;ZHU Ling;GUO Zikuan;WANG Hengxiang(Department of Hematology, General Hospital of the Air Force, Beijing 100142, China;Department of Experimental Hematology, Beijing Institute of Radiation Medicine, Beijing 100850, China)

机构地区：[1]空军总医院血液科,北京市100036 [2]北京放射与辐射医学研究所,北京市100142

出　　处：《组织工程与重建外科杂志》2017年第6期313-317,共5页Journal of Tissue Engineering and Reconstructive Surgery

基　　金：首都发展基金项目(2007-2033);国家高新技术研究发展计划(863项目;2007AA022454);国家重大新药创制基金(20092x09503-019);军队临床高新技术重大项目(2010gxjs049)

摘　　要：目的观察脐带间充质干细胞(UC-MSCs)鞘内注射治疗脊髓损伤(SCI)的临床疗效及安全性。方法对2008年1月至2013年10月收治的35例SCI患者,给予UC-MSCs鞘内注射治疗,共46疗程,每次输注细胞1×106 cells/Kg,1次/周,4次为1个疗程。采用美国脊髓损伤协会制定的脊髓损伤神经功能评分标准(ASIA标准),对患者治疗前后神经功能进行评定;采用国际神经修复学会脊髓损伤功能评价量表(IANR-SCIRFS),对患者治疗前后日常生活活动能力进行评定。结果 35例患者中22例有效,有效患者治疗结束后1个月(与治疗前相比),其痛觉、触觉、运动、日常生活活动能力评分均明显升高(P<0.01)。9例有效的患者接受了2~3个疗程治疗,7例疗效有进一步提高。25例不完全性SCI患者有效率达88%,10例完全性SCI患者均无效。治疗后个别患者出现头痛、腰痛或发热,均在1~3 d内消失。随访45~114个月(平均84个月),无治疗相关不良事件发生,有效患者疗效稳定。结论 UC-MSCs鞘内注射治疗是安全的,可改善大部分不完全性SCI患者的神经功能,多疗程治疗有可能使患者疗效得到进一步提高。To observe the clinical efficacy and safety of umbilical cord mesenchymal stem cells(UC-MSCs)in treating spinal cord injury(SCI)by intrathecal injection.Methods From January2008to October2013,35admitted patients with SCI were given UC-MSCs by intrathecal injection for46courses,at a dose of1×106cells/kg body weight once a week,4times as a course.American Spinal Injury Association(ASIA)standard and International Association of Neurorestoratology SCI Functional Rating Scale(IANR-SCIFRS)were used to evaluate SCI patient's neural function and ability of daily living.Results Among35cases,22cases were effective.Compared with the scale before therapy,effective patients'algaesthesis,tactile sensation,motion,activity of daily living scale were obviously increased one month after therapy(P<0.01).Nine effective patients received2to3courses of treatment,the effects of7cases were further enhanced.The effective rate of25cases with incomplete SCI was88.46%,whereas all of10cases with complete SCI had no response.After therapy,there were headache,lumbago or fever in individual patients and disappeared within1-3days.All patients were followed up for45months to114months(average84months),no treatment-related adverse events happened.The effect was stable in effective patients.Conclusion UC-MSCs therapy by intrathecal injection is safe,and can ameliorate most of incomplete SCI patient's neurological function,multiple courses of treatment is likely to further improve the efficacy of patients.

关 键 词：脐带间充质干细胞 脊髓损伤 鞘内注射 

分 类 号：R651.2[医药卫生—外科学]