脐带间充质干细胞移植并康复治疗脑出血后遗症1年随访

Umbilical cord mesenchymal stem cell transplantation and rehabilitation treatment for cerebral hemorrhage sequela:1 year follow-up

背景:人脐带间充质干细胞具有定向分化为神经细胞的潜能,并且已在体内外实验中得到证实。临床有关脐带间充质干细胞移植治疗脑出血的报道较少。目的:观察人脐带间充质干细胞移植联合综合康复治疗对脑出血后遗症的治疗效果。方法:脑出血患者45例按照入院单双日分为2组,治疗组22例,对照组23例。常规治疗10～18d后,存在不同程度的后遗症,治疗组通过介入途径行人脐带间充质干细胞移植及康复治疗,对照组仅给予康复治疗。结果与结论:所有病例均获12个月随访。两组治疗后1,3,6,12个月Fugl-Meyer评分及改良Barthel指数均显著高于治疗前(P<0.05),治疗后治疗组Fugl-Meyer评分及改良Barthel指数均显著高于对照组(P<0.05),肢体运动功能及日常生活活动能力均明显改善。治疗组治疗后3个月功能改善更为明显,配合综合康复治疗有协同并弥补其不足的优点,通过颅脑MRI检查及各项相关生化检查表明其有效性及安全性。提示来源于脐带中的间充质干细胞体外培养后移植治疗脑出血后遗症,无特殊不良反应,配合综合康复治疗可达到功能恢复的较好效果。

BACKGROUND：Human umbilical cord mesenchymal stem cells exhibit the potential to differentiate into neural cells,which have been confirmed in in vivo and in vitro experiments.There have been few clinical reports describing umbilical cord mesenchymal stem cells for treatment of cerebral hemorrhage.OBJECTIVE：To investigate the therapeutic effects of human umbilical cord mesenchymal stem cell transplantation combined with rehabilitation treatment for cerebral hemorrhage sequela.METHODS：Forty-five patients with cerebral hemorrhage were assigned to two groups according to admission data：treatment group（n=22） and control group（n=23）.After 10-18 days of routine treatment,each patient had sequela to different extents.The treatment group received human umbilical cord mesenchymal stem cell transplantation and rehabilitation treatment and the control group only received rehabilitation treatment.RESULTS AND CONCLUSION：All cases had been followed up for 12 months.Compared with before treatment,Fugl-Meyer scores and modified Barthel index were significantly higher at 1,3,6,12 months after treatment in each group（P 0.05）.After treatment,Fugl-Meyer scores and modified Barthel index in the experimental group were significantly higher than in the control group（P 0.05）,and body movement function and daily life activities improved obviously.After 3 months of treatment,body movement function in the treatment group was more obvious,and the involvement of rehabilitation treatment could help to compensate the shortage of simple human umbilical cord mesenchymal stem cell transplantation.Cranial MRI and related biochemistry examinations have confirmed the efficiency and safety of human umbilical cord mesenchymal stem cell transplantation combined with rehabilitation treatment.This suggests that transplantation of human umbilical cord mesenchymal stem cells cultured in vitro for treatment of cerebral hemorrhage sequela has no special adverse reactions and it can acquire better effects in recovery of body movement function after combination with rehabilitation treatment.