自体骨髓干细胞移植治疗酒精性股骨头坏死的临床观察

Clinical Observation on Transplantation of Autologous Bone Marrow Stem cells for the Treatment of Alcohol-induced Femoral Head Necrosis

【目的】探讨自体骨髓干细胞移植治疗酒精性股骨头坏死的临床疗效。【方法】对自愿接受自体骨髓干细胞移植治疗酒精性股骨头坏死的55例、68髋进行股骨头供血动脉干细胞灌注术。移植后随访观察患者髋关节疼痛程度、行走距离、髋关节活动度及影像学改变。【结果】移植后Ⅰ～Ⅲ期3～12个月患者的髋关节疼痛缓解、行走距离增加、活动度增加。48髋干细胞移后6个月,77%(37髋)在股骨头区有新生血管形成。Ⅳ期6髋中干细胞移植后,16.7%(1髋)在股骨头区有新生血管形成。术后18个月38髋行股骨头影像学检查,30髋表现为不同程度的骨质修复、死骨吸收、死骨范围缩小,有新生骨形成。【结论】自体骨髓干细胞移植治疗酒精性股骨头坏死是一种简便、安全、有效的治疗方法。

[Objective] To study the clinical effects of autologous bone marrow stem cell transplantation for the treatment of alcohol-induced necrosis of femoral head. [Methods] Fifty five cases （68 haunch bones） with alcohol-induced femoral head necrosis voluntarily accepted the transplantation of autologous bone marrow stem cells to feeding artery of the femoral heads. Post-transplantation follow-up observations included patients coxa joint pain level, walking distance, coxa joint activity and image changes. [Results] Patients with Ⅰ -Ⅲ stage in 3 to 12 months after transplantation showed the pain easement of coxa joint, the accrescence of walking distance and the augmentation of range of motion. Neovascularization was seen at 77% （37 coxas） femoral head region in 6 months after stem cell transplantation of 48 coxas.-Also neovascularization was seen at 16.7 （1 coxa） femoral head region in 6 months after stem cell transplantation of 6 coxas with Ⅳ stage. The image analysis of 30 of 38 coxa femoral heads in 18 months after transplantation showed different extent substantia ossea renovation, dead bone absorption, dead bone range diminution and neoplastic bone formation. [Conclusion] The transplantation of autologous bone marrow stem cell is a simple, safe and effective way for alcoholinduced necrosis of femoral head.