自体骨髓间充质干细胞移植治疗阿尔茨海默病4例

Autologous bone mesenchymal stem cell transplantation for Alzheimer’s disease in 4 cases

阿尔茨海默病患者10例，按治疗方法分为两组：干细胞原位治疗组6例，给予重组人粒细胞集落刺激因子150μg，腹部皮下注射，1次/d，7—10d为1个疗程：同时给予丹参注射液20mL，静脉滴注，1次/d，10d为1个疗程；自体骨髓干细胞治疗组4例，经骨髓穿刺采集自体骨髓230～330mL，分离提取骨髓单核细胞后经静脉途径和／或椎管内一次性或分次注射；注射后当日给予干细胞原位治疗。干细胞治疗前、治疗3个月后进行简易智能测量、日常生活活动能力评分及外周血细胞监测，并对患者神经功能变化及不良反应进行评价。干细胞原位治疗组6例患者未发现任何不良反应，外周血白细胞计数控制在（35～40）×10^9L^-1。治疗后3个月时简易智能测量评分及日常生活活动能力评分均高于治疗前（P〈0．05）。自体骨髓干细胞治疗组4例患者中发热2例，体温均在38℃以下，且24h后体温恢复正常；有轻微头痛3例，未行治疗24h后缓解。治疗后3个月时简易智能测量评分及日常生活活动能力评分均显著高于治疗前（P〈0．01）。骨髓间充质干细胞移植治疗阿尔茨海默病近期疗效明显，不良反应较少，与干细胞原位治疗联合应用疗效更佳，其远期疗效还需要进一步随访和观察。

Ten patients with Alzheimer＇s disease were divided into stem cell treatment in situ group （n=6）, which underwent recombined grarLulocyte colony-stimulating factor treatment （G-CSF group）, 150 μg, once per day, with 7-10 days as one treatment course, combined with Salvia miltiorrhiza intravenous injection （20 mL/d） for 10 days; autologous bone mesenchymal stem cell treatment group （MSCs, n=4）, in which bone marrow （230-330 mL） was harvested from the patients＇ ilia and then the mononuclear cells were isolated by density gradient centrifugation, and the mononuclear cells were injected intravenously or into subarachnoid space by lumber puncture once or several times. In addition, the G-CSF was subcutaneously injected on the same day （stem cell treatnTent in situ）. Before and after stem cell treatment, mini-mental state examination （MMSE）, Ability of Daily Living （ADL） and pefil：,heral blood cells were measured, and neural function and side-effects were assessed respectively. There were no side-effects in the G-CSF treated patients, and peripheral blood leucocyte was counted for 35-40×10^9 L^-1. Before and three months after G-CSF treatment, the MMSE and ADL scores were significantly improved compared with before treatment （P 〈 0.05） respectively. Two cases in the MSCs group had fever （men temperature under 38 ℃） with light headache and the symptom relieved without treatment within 24 hours. MSCs transplantation is effective and safe in short-term for patients with Alzheimer＇s disease, and more effective when combined with G-CSF treatment, but long-term curative effects need more observation.