超选动脉骨髓基质干细胞灌注治疗非创伤性股骨头坏死中长期疗效分析

Treatment of non traumatic femoral head avascular necrosis by perfusion of bone marrow stromal stem cells through optional artery

目的：研究骨髓基质干细胞经超选动脉灌注治疗非创伤性股骨头坏死的中长期疗效。方法：回顾性分析2000年1月至2004年12月接受超选动脉骨髓基质干细胞灌注治疗且随访资料完整的62例78髋非创伤性股骨头坏死患者，男35例43髋，女27例35髋；年龄22～54岁，平均36.3岁。根据术前影像学资料示ARCOI期16髋，Ⅱ期52髋，llIa期10髋；术前Han＇is评分为（64．94±8．12）分。分析患者末次随访的Harris评分，影像学变化，DSA血管变化。结果：患者术后随访9～13年，平均11年。共18髋接受人工关节置换，术前ARCOI、Ⅱ期共10髋行人工关节置换，Ⅲa期8髋行人工关节置换。末次随访Harris评分为（71．21±10．19）分，较术前有明显提高。DSA可见供应股骨头的血管有增粗、增多。结论：超选动脉骨髓基质干细胞灌注能有效治疗ARCOI、Ⅱ期非创伤性股骨头坏死，可使旋股内动脉及其分支有增粗、增多表现。

To study the medium and long term effects of perfusion of bone marrow stromal stem cells through optional artery for the treatment of non-traumatic femoral head avascular necrosis. Methods： From January 2000 to December 2004,62 cases （78 hips ） with non-traumatic femoral head necrosis accepted optional artery marrow stromal stem cells infusion treatment and had complete follow-up data, including 43 hips of 35 males and 35 hips of 27 females with an average age of 36.3 years old （22 to 54）. According to preoperative imaging data, 16 hips were ARCO I stage,52 hips were Ⅱ stage, 10 hips were Ⅲ a stage. Harris score was 64.94±8.12 preoperatively. Postoperative Harris score at the last follow-up, imaging changes, DSA vascular changes were analysis. Results： The patients were followed up for 9 to 13 years （means 11 years）. By the end of the follow-up, a total of 18 hips got artificial joint replacement, 10 hips of preoperative ARCO I , Ⅱperiod got artificial hip joint replacement, 8 hips of Ul a period got hip artificial joint replacement. Harris score was 71.21±0.19 at the end of the follow-up, it was obviously enhanced compared with preoperative. DSA showed blood vessels of supply the femoral head increased thicken- ing. Conclusion： Perfusion of bone marrow stromal stem cells through optional artery can effective treat non-traumatic femoral head necrosis of ARCO I ,Ⅱperiod,it can make the femoral circumflex artery and its branches increased thickening.