人脐带血单个核细胞静脉移植治疗轻中度阿尔茨海默病的临床研究  

A clinical study on intravenous transplantation of human umbilical cord blood mononuclear cells for treating mild-to-moderate Alzheimer disease

作　　者：孙旭 李成君 衣红杰 宋吉美 王蕾[2] SUN Xu;LI Chengjun;YI Hongjie(Qingdao West Coast New District Tradi-tional Chinese Medicine Hospital,Qingdao 266000,China)

机构地区：[1]青岛市西海岸新区中医医院,山东青岛266000 [2]山东中医药大学第二附属医院,山东济南250001 [3]广州中医药大学,广东广州510000

出　　处：《中风与神经疾病杂志》2024年第8期718-722,共5页Journal of Apoplexy and Nervous Diseases

基　　金：山东省医学会脐带血临床专项(YXH2021ZX061)。

摘　　要：目的观察人脐带血单个核细胞(hUCB-MNC)静脉移植治疗轻中度阿尔茨海默病(AD)患者的临床疗效。方法选取轻中度AD患者50例,随机分为治疗组和对照组,每组25例。治疗组给予hUCB-MNC静脉输注,对照组给予盐酸多奈哌齐口服,两组疗程均为12周。评价两组治疗前后磁共振质子波谱技术(1H-MRS)中N-乙酰天冬氨酸/肌酸(NAA/Cr)、胆碱/肌酸(Cho/Cr)、肌醇/肌酸(mI/Cr)、N-乙酰天冬氨酸/肌醇(NAA/mI)比值、尿AD7c-NTP水平、蒙特利尔认知评估量表(MoCA)得分。结果治疗组治疗后较治疗前MoCA总分及各认知域评分提高,尤其在记忆力、视空间与执行力、注意力、定向力领域的提高优于对照组(P<0.05)。治疗组治疗后较治疗前NAA/Cr、Cho/Cr、NAA/mI升高,mI/Cr降低(P<0.05),且治疗组NAA/Cr、Cho/Cr、NAA/mI、mI/Cr改善程度优于对照组(P<0.05)。治疗组治疗后较治疗前尿AD7c-NTP水平降低,且治疗组尿AD7c-NTP改善程度优于对照组(P<0.05)。结论hUCB-MNC可明显改善轻中度AD患者的记忆力、视空间与执行力等认知域,并且能改善轻中度AD患者的脑代谢水平及减轻神经元损伤程度,1 H-MRS结合尿AD7c-NTP的评估模式可为临床治疗AD提供新的思路和方法。Objective To observe the clinical efficacy of intravenous transplantation of human umbilical cord blood mononuclear cells(hUCB-MNC)in the treatment of patients with mild-to-moderate Alzheimer disease(AD).Methods Fifty patients with mild-to-moderate AD were randomly divided into treatment group and control group,with 25 cases in each group.The treatment group received intravenous infusion of hUCB-MNC,while the control group was given donepezil hydrochloride by oral administration.The course of treatment was 12 weeks in both groups.We evaluated 1H-proton magnetic resonance spectroscopy(1H-MRS)parameters[N-acetylaspartate/creatinine(NAA/Cr),choline/creatinine(Cho/Cr),inositol/creatinine(mI/Cr),and N-acetylaspartate/inositol(NAA/mI)ratios],urinary AD7c-NTP level,and Montreal Cognitive Assessment(MoCA)score in both groups before and after treatment.Results After treatment,the treatment group showed significant increases in the total MoCA score and the score of each cognitive domain;and the treatment group had significant greater improvements in memory,visuospatial and executive function,attention,and orientation than the control group(all P<0.05).After treatment,the treatment group showed significantly increased NAA/Cr,Cho/Cr,and NAA/mI ratios and a significantly decreased mI/Cr ratio;and the improvements in NAA/Cr,Cho/Cr,NAA/mI,and mI/Cr were significantly greater in the treatment group than in the control group(all P<0.05).The urinary AD7c-NTP level in the treatment group was significantly reduced after treatment,and the improvement was significantly better compared with the control group(both P<0.05).Conclusion Intravenous transplantation of hUCB-MNC can significantly improve memory,visuospatial and executive function,and other cognitive domains as well as brain metabolism and neuronal damage in patients with mild-to-moderate AD.1H-MRS and urinary AD7c-NTP evaluations can provide new ideas for the clinical treatment of AD.

关 键 词：脐带血单个核细胞 阿尔茨海默病 静脉移植 

分 类 号：R749.16[医药卫生—神经病学与精神病学]