成体干细胞治疗20例运动神经元病临床效果观察

Clinical effect of adult stem cell application in motor neuron disease in 20 cases

目的 探讨成体干细胞治疗运动神经元病（MND）的可行性.方法 我科2008年5月至2010年3月住院的MND患者20例,分为2组,其中一组14例采用脐带间充质干细胞治疗,另一组6例采用自体分选干细胞（本实验室免疫磁株分选）治疗.直接将4 ml的脐带间充质干细胞或自体分选干细胞液经腰椎穿刺注射到患者蛛网膜下腔,每次注射的细胞数1.0×107,同时配合功能康复锻炼.结果 7例取得进步,治疗2周后呛咳、吞咽困难逐渐好转,语言的连续性增加,思维反应有改善;7例取得显效,四肢力量增强,肌力由Ⅲ级增加到Ⅳ级;6例无效,两种干细胞疗效差异无统计学意义（u=37,P＞0.05）.其中3例随访3～6个月内死亡;随访18～24个月的3例患者,病情无加重.结论 成体干细胞治疗运动神经元病安全可行.

Objective To study the feasibility of adult stem cell therapy in motor neuron disease. Methods From May 2008 to March 2010, twenty patients with motor neuron disease were treated with adult stem cell. The patients were divided into two groups with umbilical cord mesenchymal stem cell in 14 cases （group A）and autologous Hematopoietic stem cell in 6 cases（ group B）. 4 ml stem cell （ 〉 1.0 × 107） were given through subarachnoid injection. 1.0 × 107 cell were injected each time, and rehabilitation were performed simultaneously. Results Seven patients have improved in the dysphagia, bucking, continuity of language and thinking and reaction after 2 weeks＇ treatment. Seven patients improved remarkably in myodynamia（ from Ⅲ to Ⅳ ）. There was no effect observed in 6 patients. Three patients died during the follow up for 3 - 6 months. Three patients were followed up for 18 to 24 months and their condition did not getting worse. Conclusion Adult stem cell transplantation may be a safe and practical new ways to treat motor neuron disease.