骨髓间充质干细胞移植术对蛛网膜下腔出血脑损伤的防治效果研究  

Preventive and therapeutic effects of bone marrow mesenchymal stem cell transplantation on subarachnoid hemorrhage induced brain injury

作　　者：伏帅 赵威 FU Shuai;ZHAO Wei(Emergency Department,The Second Affiliated Hospital of Henan University of Science and Technology,Luoyang,Henan 471000,China)

机构地区：[1]河南科技大学第二附属医院急诊科,河南洛阳471000

出　　处：《中国医学工程》2025年第2期49-53,共5页China Medical Engineering

基　　金：河南省医学科技攻关项目(LHGJ2021021026)。

摘　　要：目的 观察骨髓间充质干细胞(BMSCs)移植术对蛛网膜下腔出血(SAH)患者脑损伤的防治效果。方法 该次研究为前瞻性研究,选取2021年12月至2023年12月期间河南科技大学第二附属医院收治的108例SAH患者为研究对象,采用计算机随机分组法将入组患者分别列为常规组(54例)和BMSCs组(54例),常规组予以常规治疗,BMSCs组采用BMSCs移植术辅助治疗,比较两组患者的血管内皮功能、氧化应激指标、神经功能及预后情况。结果 在不同治疗方案下,BMSCs组治疗1 d、3 d、5 d、7 d后的内皮素-1 (ET-1)水平分别为(60.23±10.45) ng/L、(54.49±10.27) ng/L、(48.66±10.37)ng/L、(42.19±10.25)ng/L,均低于常规组[(65.44±10.22)ng/L、(59.65±10.37)ng/L、(53.25±10.41)ng/L、(47.62±10.38) ng/L](P<0.05);一氧化氮(NO)水平分别为(45.22±10.25)μmol/L、(52.38±10.41)μmol/L、(58.25±10.33)μmol/L、(64.33±10.41)μmol/L,均高于常规组[(40.39±10.44)μmol/L、(47.65±10.23)μmol/L、(53.41±10.32)μmol/L、(59.44±10.21)μmol/L](P<0.05);BMSCs组的超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)分别为(85.45±10.23) U/mL、(135.29±20.36) U/L,均高于常规组[(80.25±10.41) U/mL、(120.44±20.39) U/L],丙二醛(MDA)[(5.36±1.29) nmol/L]低于常规组[(6.22±1.65) nmol/L](P<0.05);BMSCs组的半乳糖凝集素3 (Galectin-3)、粒细胞巨噬细胞-集落刺激因子(GM-CSF)、神经肽Y (NPY)分别为(5.35±1.22)μg/L、(8.31±1.55)×10~3/mm^(3)、(187.66±20.41) pg/mL,均低于常规组[(6.28±1.44)μg/L、(10.41±2.36)×10~3/mm^(3)、(201.45±20.47) pg/mL](P<0.05);BMSCs组的格拉斯哥预后指数(GOS)[(4.52±1.36)分]高于常规组[(3.77±0.82)分],改良Fisher量表(mFS)评分[(1.44±0.23)分]低于常规组[(2.25±0.79)分](P<0.05)。结论 BMSCs移植术能减轻SAH患者的血管内皮损伤及氧化应激损伤,对促进患者神经功能恢复、避免继发脑损伤并改善患者预后情况均有积极意义。【Objective】 To observe the preventive and therapeutic effects of bone marrow mesenchymal stem cells(BMSCs)transplantation on brain injury in subarachnoid hemorrhage(SAH) patients.【Methods】 This study was a prospective study.The study subjects were randomly selected from 108 SAH patients admitted to the Second Affiliated Hospital of Henan University of Science and Technology from December 2021 to December 2023.The enrolled patients were divided into a conventional group(54cases) and a BMSCs group(54 cases) using computer random grouping method.The conventional group received conventional treatment,while the BMSCs group received BMSCs transplantation as an adjuvant treatment.The vascular endothelial function,oxidative stress indicators,neurological function,and prognosis of the two groups of patients were compared.【Results】 Under different treatment regimens,the ET-1 levels in the BMSCs group after 1 day,3 days,5 days,and 7 days of treatment were 60.23±10.45 ng/L,54.49±10.27 ng/L,48.66±10.37 ng/L,and 42.19±10.25 ng/L,lower than the conventional group(65.44±10.22 ng/L,59.65±10.37 ng/L,53.25±10.41 ng/L,and 47.62±10.38 ng/L)(P<0.05).The NO levels were 45.22±10.25 μmol/L,52.38±10.41μmol/L,58.25±10.33 μmol/L,64.33±10.41 μmol/L,higher than the conventional group(40.39±10.44 μmol/L,47.65±10.23 μmol/L,53.41±10.32 μmol/L,59.44±10.21 μmol/L)(P<0.05).The SOD and GSH-Px of the BMSCs group(85.45±10.23 U/mL and 135.29±20.36 U/L) were higher than the conventional group(80.25±10.41 U/mL and 120.44±20.39 U/L),and MDA(5.36±1.29 nmol/L) was lower than the conventional group(6.22±1.65 nmol/L)(P<0.05).The Galectin-3,GM-CSF,and NPY of BMSCs group were 5.35±1.22 μg/L,(8.31±1.55)×10~3/mm~3,187.66±20.41 pg/mL,lower than the conventional group [6.28±1.44 μg/L,(10.41±2.36)×10~3/mm~3,201.45±20.47 pg/mL](P<0.05).The GOS score of the BMSCs group(4.52±1.36) was higher than the conventional group(3.77±0.82),while the mFS score(1.44±0.23) was lower than the conventional group(2.25±0.79)(P<0.0

关 键 词：蛛网膜下腔出血 骨髓间充质干细胞移植 血管内皮功能 脑损伤 预后情况 

分 类 号：R743.35[医药卫生—神经病学与精神病学]