嗅鞘细胞移植治疗晚期脊髓损伤的长期安全性评价:磁共振成像3年随访

Long-term safety of fetal olfactory ensheathing glial cell transplantation in treatment of malignant spinal cord injury: A 3-year follow-up with magnetic resonance imaging

目的:在证明嗅鞘细胞移植治疗晚期脊髓损伤的近期安全性和有效性的基础上,进一步评价其长期的安全性。方法:选择2001-11/2002-12北京西山医院神经疾病研究治疗中心收治的晚期脊髓损伤患者171例,随机选择其中10例纳入本组观察,男9例,女1例;年龄22～55岁,平均36.7岁;病程1.5～8年,平均4.4年;受伤原因包括车祸、摔伤、医源性损伤、机器挤压伤等。所有患者均接受胚胎嗅鞘细胞移植治疗,即取胚胎嗅球,消化成单个嗅鞘细胞后,培养两三周,然后移植到患者脊髓损伤部位的上下处。术后采用1.5TMRI脊髓扫描定期随访,观察嗅鞘细胞移植物的生物安全性。结果:10例患者平均获随访3.2年,均进入结果分析。术前MRI表现均有脊髓软化,变形,囊肿,瘢痕形成并萎缩。随访期间,患者无细胞移植相关性副反应。术前术后MRI扫描对比,脊髓移植部位及其周围未发现新生肿瘤、出血、水肿、囊肿形成、神经结构破坏以及感染(脓肿)等病理性改变。结论:采用嗅鞘细胞移植手术治疗脊髓损伤患者,3年随访MRI成像无异常所见,是安全的。

AIM： The safety in the near feature of the olfactory ensheathing glial cells （OECs） transplantation for the treatment of the patients with malignant sPinal cord injuries （SCI） is proved, then to further evaluate its long-term safety. METHODS： We chose 171 patients with malignant spinal cord injury who received the treatment at the Researeh and Treatment Center for Neurologic Disease of Beijing Xishan Hospital between November 2001 and December 2002.10 of them were chosen randomly as subjects including 9 male and 1 female, with the average of 36.7 years ranging from 22 to 55 years old, and the disease course was 4.4 years on average ranging from 1.5 to 8 years; The factors causing injury included traffic accident, wound, iatrogenic injury, extrusion injury by machine and so on. All the patients received embryonic： OECs transplantation, that was embryonic olfactory bulb was chosen and digested into single OEC, then cultured for 2 to 3 weeks, afterwards, was transplanted to the peripheral region of the injured site of the patients. After operation, spinal cord scanning was performed with 1.5 MRI for periodically follow-up and safety of the transplantation of OECs was observed. RESULTS： Ten patients were followed up for 3.2 vears on average, and all the patients entered the stage of result analysis. Before operation, MRI all showed that spinal intenerates, deformation, cyst, formation of scar and atrophy. During follow -up, there were no cell transplantation related side effect. There was no newborn tumor, hemorrhage, edema, cyst formation, destruction of neural structure and infection （abscess） and other pathological change in the peripheral region and transplantation site of spinal cord in all the patients studied. CONCLUSION： It is safe without abnormality to treat spinal cord injury through OEC transplantation showed by MRI of 3-year follow up