人脐带血间充质干细胞治疗膝关节小范围软骨缺损疗效研究  

Effect of human umbilical cord mesenchymal stem cells in the treatment of small-scale cartilage defect of knee joint

作　　者：孙月 沈阳 刘铭 刘松波 赵根 刘欣伟 SUN Yue;SHEN Yang;LIU Ming;LIU Song-bo;ZHAO Gen;LIU Xin-wei(Room of Medical Information&Data,General Hospital of Northern Theater Command,Shenyang 110016,China)

机构地区：[1]北部战区总医院医学信息数据室,辽宁沈阳110016 [2]北部战区总医院骨科全军重症战创伤救治中心,辽宁沈阳110016 [3]大连医科大学北部战区总医院研究生联合培养基地,辽宁沈阳110016

出　　处：《创伤与急危重病医学》2022年第3期191-194,共4页Trauma and Critical Care Medicine

基　　金：沈阳联勤保障中心自选科研项目(2020-485)。

摘　　要：目的探讨膝关节腔内注射人脐带血间充质干细胞(UC-MSCs)治疗膝关节小范围软骨缺损的临床疗效和安全性。方法选取自2020年8月至2021年1月收治的31例膝关节软骨损伤患者为研究对象。根据随机数字表法将患者分为微骨折术组(A组,n=10),UC-MSCs注射组(B组,n=10)和微骨折术联合UC-MSCs注射组(C组,n=11)。A组行微骨折术,B组在关节镜探查1个月后分别于第1、4周向膝关节腔内注射UC-MSCs,C组在接受微骨折术治疗1个月后分别于第1、4周向膝关节腔内注射UC-MSCs,记录3组患者术后切口愈合情况及手术并发症,比较接受治疗前及治疗后3、6、12个月Lysholm评分及Tegner评分的差异。结果治疗后,3组患者的Lysholm、Tegner评分均有所提高,治疗后各随访节点Lysholm、Tegner评分较前一次随访均有提高,差异有统计学意义(P<0.05)。治疗前及接受治疗后3个月,3组患者的Lysholm、Tegner评分组间比较,差异无统计学意义(P>0.05);治疗后6、12个月,B、C组患者的Lysholm、Tegner评分均高于A组,差异有统计学意义(P<0.05);B、C两组各随访时间点Lysholm、Tegner评分比较,差异无统计学意义(P>0.05)。B、C组各有2例患者在接受UC-MSCs注射治疗后,膝关节出现局部发热、肿胀,予以外敷冰袋对症处理,1周后症状均消失,其余患者均未见明显异常,切口愈合良好,无感染及静脉血栓等并发症发生。结论膝关节小范围软骨缺损应用UC-MSCs注射能获得满意疗效,作为一种新型治疗方法,其中远期疗效尚需进一步研究。Objective To investigate the clinical efficacy and safety of intra-articular injection of human umbilical cord blood mesenchymal stem cells(UC-MSCs)in the treatment of small-scale cartilage defects in the knee joint.Methods Thirty-one patients with knee cartilage injury who were admitted from August 2020 to January 2021 were selected as the research objects.According to the random number table method,the patients were divided into microfracture group(group A,n=10),UC-MSCs injection group(group B,n=10)and microfracture combined with UC-MSCs injection group(group C,n=11).Group A underwent microfracture surgery,group B was injected with UC-MSCs into the knee joint cavity at the 1st and 4th week after arthroscopic exploration for 1 month,and group C,UC-MSCs were injected into the knee joint cavity at the 1st and 4th week after microfracture treatment for 1 month,the postoperative incision healing and surgical complications of the 3 groups were recorded,and the differences in Lysholm score and Tegner score before and 3,6,and 12 months after treatment were compared.Results After treatment,the Lysholm and Tegner scores of the three groups of patients were improved.After treatment,the Lysholm and Tegner scores of each follow-up node were improved compared with the previous follow-up,and the difference was statistically significant(P<0.05).Before treatment and 3 months after treatment,there was no significant difference in Lysholm and Tegner scores between the three groups(P>0.05).The scores were higher than those in group A,and the difference was statistically significant(P<0.05).There was no significant difference in Lysholm and Tegner scores between groups B and C at each follow-up time point(P>0.05).After receiving UC-MSCs injection,2 patients in each group B and C developed local fever and swelling in the knee joint.They were treated with external ice packs.The symptoms disappeared after 1 week.The other patients showed no obvious abnormality and the incision healed well,no complications such as infection and venous

关 键 词：膝关节软骨损伤 人脐带血间充质干细胞 微骨折术 

分 类 号：R68[医药卫生—骨科学]