关节内注射脐带血单个核细胞治疗膝骨关节炎  

Intra-articular injection of umbilical cord blood mononuclear cells for treatment of knee osteoarthritis

作　　者：靳文舒 王哲 岳耀辉 李树锋 闫新峰 JIN Wen-shu;WANG Zhe;YUE Yao-hui;LI Shu-feng;YAN Xin-feng(The first affiliated Hospital of Shandong first Medical University,Jinan 250014,China)

机构地区：[1]山东第一医科大学第一附属医院,山东济南250014

出　　处：《中国矫形外科杂志》2023年第6期555-558,共4页Orthopedic Journal of China

基　　金：山东省自然科学基金项目(编号:ZR2019MH130)。

摘　　要：[目的]探讨脐带血单个核细胞(umbilical cord blood mononuclear cells, UCB-MNCs)治疗膝关节骨关节炎(knee osteoarthritis, KOA)的临床疗效和安全性。[方法] 2021年2月—2022年9月,30例早、中期KOA患者接受膝关节腔内注射2×10^(8)(3 ml) UCB-MNCs治疗2次,间隔1个月。评估临床与影像资料。[结果]所有患者均顺利完成注射,主要不良反应为注射数天内关节肿胀和疼痛,但不影响关节功能活动。治疗前后血常规、血沉、C反应蛋白以及肝功能、肾功能均无显著变化。随访6个月以上,随时间推移,患者疼痛和肿胀的VAS评分,以及WOMAC的疼痛、僵硬、功能、总体评分均显著降低(P<0.05),而KOOS各子项评分均显著提高(P<0.05)。影像方面,与治疗前相比,治疗3个月后X线片显示内侧、外侧和髌股室的K-L评级均无显著变化(P>0.05);内侧室MOAKS无显著变化(P>0.05),而外侧室和髌股室MOAKS显著下降(P<0.05)。[结论]KOA患者膝关节腔内注射UCB-MNCs治疗能有效缓解疼痛,改善功能。[Objective] To explore the clinical efficacy and safety of intra-articular injection of umbilical cord blood mononuclear cells(UCB-MNCs) for treatment of knee osteoarthritis(KOA). [Methods] From February 2021 to September 2022, 30 patients received intraventricular injection of 2×10^(8)(3 ml) UCB-MNCs twice with one month apart for early-and mid-stage KOA. The clinical and imaging data were evaluated. [Results] All the patients had the injection completed successfully, with the main adverse reactions of joint swelling and pain within a few days after injection, whereas which not affected functional activities of the joint. There were no significant changes in blood routine,erythrocyte sedimentation, C-reactive protein, liver function and kidney function before and after treatment. As time went during the followup lasted for 6 months, the VAS scores for pain and swelling, as well as WOMAC pain, stiffness, function, and overall scores significantly decreased(P<0.05), while all KOOS subscores significantly increased(P<0.05). Radiographically, the Kellgren-Lawrence grades in the medial, lateral and patellofemoral compartments remained unchanged(P>0.05), the MRI Osteoarthritis Knee Score(MOAKS) of the medial compartment was not changed either(P>0.05), while the MOAKS scores of the lateral and patellofemoral compartments significantly decreased3 months after treatment compared with those before treatment(P<0.05). [Conclusion] Intra-articular injection of UCB-MNCs for KOA does effectively relieve pain and improve function in this trial.

关 键 词：脐带血 单个核细胞 膝关节骨关节炎 软骨 干细胞 

分 类 号：R681.57[医药卫生—骨科学]