自体骨髓间充质干细胞移植治疗脑梗死:6个月随访

Treatment of cerebral infarction using autologous marrow mesenchymal stem cells transplantation:A six-month follow-up

目的:观察骨髓间充质干细胞移植治疗脑梗死的临床疗效和安全性。方法:本院2003-06/2008-06收治的脑梗死患者120例,均符合1995年全国第四届脑血管病会议制定的诊断标准,随机分为4组:对照组、单纯干细胞动员组、单纯干细胞移植组、联合组,30例/组。对照组采用常规药物治疗与康复训练;单纯干细胞动员组在对照组治疗的基础上,给予重组人粒细胞集落刺激因子150μg腹部皮下注射;单纯干细胞移植组在对照组治疗的基础上,经静脉移植自体骨髓间充质干细胞(16.2～51.3)×108;联合组综合上述3组方法进行治疗。结果:①与对照组比较,治疗后4周、12周、6个月单纯干细胞动员组、单纯干细胞移植组、联合组Fugl-Meyer运动功能评分、功能独立性评定量表评分均显著好转(P<0.05或P<0.01);且联合组治疗效果最佳,疗效明显优于单纯干细胞动员组、单纯干细胞移植组(P<0.05)。②治疗后14d内,单纯干细胞动员组未发现任何不良反应;单纯干细胞移植组发热4例,体温均在38℃以下,且24h后体温恢复正常,轻微头痛3例,未行治疗24h后缓解;联合组发热5例,体温均在38℃以下,且24h后体温恢复正常,轻微头痛3例,未行治疗24h后缓解。结论:骨髓间充质干细胞移植治疗脑梗死近期疗效明显,不良反应较少。

OBJECTIVE： To observe the curative effect and safety of autologous marrow mesenchymal stem cells （MSCs） transplantation on treating cerebral infarction. METHODS： Totally 120 cerebral infarction patients enrolled at the Qilu Hospital of Shandong University from June 2003 to June 2008 was collected, and diagnosed as ischemic stroke according to the diagnosis standard published on the collection of National Fourth Cerebral Vascular Disease Conference. All patients were divided into control, stem cell mobilization, stem cell transplantation, and combined treatment groups, with 30 cases in each group. In the control group patients were treated with routine medication and rehabilitation training. Patients in the stem cell mobilization group were received 150 pg filgrastim at abdominal subcutaneous injection as well as the routine medication. In the stem cell transplantation group, patients were vein transplanted （16.2-51.3）×10^8 MSCs based on the routine medication. In the combined treatment group, the above methods performed simultaneously. RESULTS： Compared to the control group, scoring with Fugl-Meyer （FMA） and Function Independence Measure （FIM） was obvious improved in the other groups at the weeks 4, 12 and months 6 after treatment （P 〈 0.05 or P 〈 0.01）, especially in the combined treatment group, the curative effect of which was superior to stem cell mobilization and stem cell transplantation groups （P 〈 0.05）. Within 14 days after treatment, no adverse effect appeared in the stem cell mobilization group; 4 patients had fever in the stem cell transplantation group, with body temperature below 38℃ and returned to a normal level after 24 hours, 3 patients suffered mild headache and released after 24 hours without treatment; in the combined treatment group, 4 patients had fever with body temperature below 38℃ and returned to a normal level after 24 hours, 3 patients suffered mild headache and released after 24 hours without treatment. CONCLUSION： MSCs transplantation obtains an excellent curative effect on treating cerebral infarction, and the adverse effects are few.