脊髓损伤传统治疗及细胞移植基因治疗的进展

Progress in the conventional therapy,cell transplantation and gene therapy for spinal cord injury

目的:脊髓损伤分为原发性损伤和继发性损伤,治疗主要目的在于阻止或减少继发性损伤。文章对采用传统疗法、细胞移植、基因治疗等方式修复脊髓损伤的研究进展作一综述。资料来源:应用计算机检索PUBMED1997-02/2007-02期间的相关文章,检索词为“Spinal Cord Injuries,surgery,transplants,gene cure”,并限定文章语言种类为English。同时计算机检索中国期刊全文数据库2001-01/2006-12期间的相关文章,检索词为“脊髓损伤,基因治疗,细胞移植,手术治疗”,并限定文章语言种类为中文。资料选择:对资料进行初审,并查看每篇文献后的引文。纳入标准:文章所述内容应与传统疗法、细胞移植或基因治疗等方式修复脊髓损伤相关。排除标准:重复研究或Meta分析类文章。资料提炼:共收集到98篇相关文献,32篇文献符合纳入标准,排除的66篇文献为内容陈旧或重复。符合纳入标准的32篇文献中,分别涉及手术治疗、药物治疗、高压氧治疗、细胞移植、基因治疗脊髓损伤以及所面临的问题。资料综合:脊髓损伤采取手术治疗可解除脊髓压迫和(或)通过体内固定维持脊柱稳定性;药物、高压氧等非手术治疗是通过减轻脊髓继发性损伤,从而促进神经功能的恢复或再生;细胞移植、基因治疗可刺激神经细胞再生。脊髓损伤后的修复面临许多问题,主要是损伤后脊髓中的环境不利于修复的发生和发展。结论:细胞移植和基因治疗是脊髓损伤修复的重要手段,在动物实验中已取得了一定效果,具有很好的临床应用前景。

OBJECTIVE： Spinal cord injuries include original injury and secondary injury. The aim of therapy is to prevent and reduce the secondary injury. The paper summarizes the research headway of spinal cord injury therapy about conventional therapy, cell transplantation and gene therapy. DATA SOURCES.The relevant articles published between February 1997 and February 2007 were searched for in PUBMED database with the key words of “Spinal Cord Injuries; surgery; transplants; gene cure” in English. Simultaneously, the relevant Chinese articles between January 2001 and December 2006 were search for in China Journal Full-text Database （CJFD） with the key words of “Spinal Cord Injuries, gene cure, cell transplants, operation.” STUDY SELECTION： The literatures were selected primarily and the quotation of each literature was examined. Inclusive criteria： The articles should include spinal cord injury therapy about conventional therapy, cell transplantation or gene therapy. Exclusive criteria included articles with the duplicated study or Meta analysis. DATA EXTRACTION-Totally 98 literatures were collected, and 32 of them met the inclusive criteria, and the excluded 66 articles were with the repetition of the same research and out of date. Among the 32 selected literatures, they were involved in the operation, drug therapy, hyperbaric oxygen therapy, cell transplantation and gene therapy to the spinal cord injuries and the problem up against. DATA SYNTHESLS： Surgery can both relieve the pressure of spinal cord and maintain the spinal stability through the inner fixation. Drug and hyperbaric oxygen therapy can promote the recovery or regeneration of the nerve function through relieving the secondary injury of spinal cord, Cell transplantation and gene therapy can stimulate the regeneration of nerve cells. There are many difficulties for the repairing after spinal cord injuries and the most of all is the environment in the spinal cord that make against the repairing. CONCLUSION：Cell transplantation and gene therapy are the most important means for the therapy of spinal cord injuries and there have make achievements in the animal experiment, Cell transplantation and gene therapy have a great clinical utilization.