机械取栓联合脐带血单个核细胞移植改善急性颅内大血管闭塞性缺血性脑卒中患者预后的研究  

Safety and efficacy of mechanical thrombectomy combined with umbilical cord blood mononuclear cell transplantation in improving the prognosis of patients with acute ischemic stroke due to large vessel occlusion

作　　者：李中辰 郝继恒[1] 张文玉 司俊臣 张萌[1] 王子栋 王培健 张利勇[1] LI Zhongchen;HAO Jiheng;ZHANG Wenyu(Liaocheng People’s Hospital,Liaocheng 252000,China)

机构地区：[1]聊城市人民医院,山东聊城252000

出　　处：《中风与神经疾病杂志》2025年第1期47-51,共5页Journal of Apoplexy and Nervous Diseases

基　　金：山东省医学会脐带血科研专项基金(YXH2020ZX002);山东省医药卫生科技发展计划(202104090566)。

摘　　要：目的 探讨机械取栓联合脐带血单个核细胞微移植治疗急性颅内大血管闭塞性缺血性脑卒中患者的安全性和有效性。方法 前瞻性选取2021年2月—2023年2月就诊于聊城市人民医院接受机械取栓治疗的61例急性颅内前循环大血管闭塞性缺血性脑卒中患者。随机分入实验组与对照组,实验组行机械取栓联合脐带血单个核细胞微移植;对照组行机械取栓;两组患者在常规药物治疗方面无差异,采用Mann-Whitney U检验、卡方检验及Logistic回归分析等方法,以P<0.05为差异有统计学意义。结果 两组患者治疗后90 d和180 d血液化验及影像学结果无明显异常。神经功能缺损程度(NIHSS评分):术前及术后1 d、3 d、7 d、30 d NIHSS评分差异无统计学意义(P>0.05);总有效率(术后90 d mRS≤2的比例):实验组总有效率为41.4%(12/29),高于对照组的32.2%(10/31)(P>0.05),但差异无统计学意义(P>0.05);肢体运动功能(FMA评分):术前FMA评分差异无统计学意义(P>0.05);术后90 d FMA评分实验组优于对照组,差异有统计学意义(P<0.05)。结论 机械取栓联合脐带血单个核细胞微移植可以有效改善患者长期功能预后,且具有较高的安全性。Objective To investigate the safety and efficacy of mechanical thrombectomy combined with umbilical cord blood mononuclear cell microtransplantation in the treatment of patients with acute ischemic stroke due to large vessel occlusion.Methods A prospective study was conducted among 61 patients with acute ischemic stroke due to large vessel occlusion in the anterior intracranial circulation who underwent mechanical thrombectomy in our hospital from February 2021 to February 2023,and they were randomly divided into experimental group and control group.The patients in the experimental group underwent mechanical thrombectomy combined with umbilical cord blood mononuclear cell microtransplantation,while those in the control group underwent mechanical thrombectomy alone,and there was no difference in conventional drug treatment between the two groups.The Mann-Whitney U test,chi-square test,and logistic regression analysis were used,with P<0.05 indicating statistical significance.Results There were no significant abnormalities in blood tests and imaging findings in either group at 90 days and 6 months after treatment.There was no significant difference in the degree of neurological deficit(NIHSS score)between the two groups before surgery and on days 1,3,7,and 30 after surgery(P>0.05).The experimental group had a higher overall response rate(the proportion of patients with an mRS score of≤2 on day 90 after surgery)than the control group[41.4%(12/29)vs 32.2%(10/31),P>0.05].There was no significant difference in limb motor function[Fugl-Meyer Assessment(FMA)score]between the two groups before surgery(P>0.05),and the experimental group had a better FMA score than the control group on day 90 after surgery(P<0.05).Conclusion Mechanical thrombectomy combined with umbilical cord blood mononuclear cell microtransplantation can effectively improve the long-term functional prognosis of patients,with a favorable safety profile.

关 键 词：急性大血管闭塞 脑梗死 机械取栓 脐带血单个核细胞 治疗效果 

分 类 号：R743.3[医药卫生—神经病学与精神病学]