胚胎嗅鞘细胞移植治疗脑性瘫痪:4例术后4周结果报告

Embryo olfactory ensheathing cell transplantation for cerebral palsy:A result report of 4 cases 4 weeks after transplantation

目的:观察胚胎嗅鞘细胞移植治疗脑性瘫痪的有效性和安全性。方法:①病例资料:4例因出生时缺血缺氧确诊为脑性瘫痪的患者,男2例,女2例,年龄分别为14岁、岁、个月、岁。嗅92817鞘细胞由北京市虹天济神经科学研究院细胞中心提供,实验经医学伦理委员会批准,4例脑性瘫痪患者均签署知情同意书。②实验方法:根据术前MRI或CT片,患者均在局麻下行微创立体定向嗅鞘细胞移植术,选取双额放射冠为注射靶点,每侧注射1.0×106个细胞。术后给予止血、抗感染、康复等常规处理。③实验评估:分别于嗅鞘细胞移植前、移植后4周采用脑瘫综合功能评定量表、脑瘫日常生活能力量表评价患者神经功能及生活质量的改善。结果:①嗅鞘细胞移植术后4周,4例患者较术前均有不同程度的神经功能改善,未出现手术并发症。②脑瘫综合功能评定总分:病例1由92.5分增至94分,病例2由55分增至56分,病例3由10.5分增至11.5分,病例4由9.5分增至13分。③脑性瘫痪日常生活能力量表总分:病例1由82.0分增至83.5分,病例2无变化,为16.5分,病例3由5.0分增至7.5分,病例4由5.0分增至8分。结论:嗅鞘细胞移植治疗脑性瘫痪患者近期评价安全可行,可部分改善神经功能与生活质量,长期效果有待进一步随访。

AIM： To study the reliability and effectiveness of embryo olfactory ensheathing cell （OECs） transplantation in the treatment of cerebral palsy. METHODS： ①Four patients who were diagnosis as cerebral palsy due to the ischemia and hypoxia when they were bom were enrolled, including two boys and two girls. The ages were 14 years old, 9 years old, 28 months and 17 years old, respectively. The embryo OECs were provided by cell center of Beijing Hongtianji Neuroscience Academy and the experiment was approved by Medical Ethics Committee. All the four patients signed the informed consent.②According to pre-operative MRI or CT, the patients received minimal invasive stereotaxis OECs transplantation under local anesthesia. Corona radiata of both frontal regions was considered as injection target with 1.0×10^6 cells at each side. Conventional disposals were done such as hematischesis, anti-infection and rehabilitation after transplantation. ③Cerebral Palsy General Function Rating Scale and Cerebral Palsy Activities of Daily Living Rating Scale were used to evaluate neural function and quality of life of the patients before the transplantation and 4 weeks after the transplantation, respectively. RESULTS： ①The four patients all had some neurological amelioration to different degrees, without the complications 4 weeks after the transplantation.②The general score of Cerebral Palsy General Function Rating Scale： The general score increased from 92.5 points to 94 points in case 1, increased from 55 points to 56 points in case 2, increased from 10.5 points to 11.5 points in case 3 and increased from 9.5 points to 13 points in case 4. ③The general score of Cerebral Palsy Activities of Daily Living Rating Scale： The general score increased from 82.0 points to 83.5 points in case 1, increased from 5.0 points to 7.5 points in case 3, increased from 5.0 points to 8 points in case 4 and no change in case 2 was found and the score was 16.5 points. CONCLUSION： Embryo OEC transplantation in the treatment of cerebral palsy is safe and feasible which can improve the neurological function of cerebral palsy partly and quality of life to some patients. The long-term outcome of the treatment is required to be followed up.