单侧、双侧髂骨取血及取血量与骨髓单个核细胞浓度与早期股骨头坏死治疗效果的关系(英文)

Effect of quality and quantity of blood taken from unilateral and bilateral iliac on the concentration of bone marrow mononuclear cells and the efficacy of bone marrow mononuclear cells transplantation for the treatment of early femoral head necrosis

背景:以单侧、双侧髂骨取血及取血量是否会影响骨髓单个核核细胞的浓度呢?目的:观察自体骨髓单个核细胞浓度差异对移植治疗早期股骨头坏死的疗效影响。方法:回顾性分析髓心减压加自体单个核细胞移植股骨头坏死患者 120 例/168 髋临床资料,其中单侧髂骨取血 200 mL,27 例/39 髋,单侧髂骨取血 300 mL,29例/40 髋;双侧髂骨取血 200 mL,30 例/42髋,双侧髂骨取血 300 mL,34 例/47 髋。髂骨取血后在细胞分离机将骨髓血梯度离心,细胞分离前后行单个核细胞计数,髓芯减压后移植注入骨坏死区。随访12～36 个月,观察治疗前后患者 CT 影像学及髋关节 Harris 评分改变。结果与结论 : 单侧及双侧髂骨取血200 mL 分离后所得单个核细胞计数与取血300 mL比较,差异均无显著性意义(P >0.05),但双侧明显高于单侧(P < 0.01)。各组髋关节功能 Harris 评分,移植前比较差异无显著性意义(P > 0.05),移植后Harris 评分及优良率显著提高(P < 0.05,P < 0.01)。与单侧髂骨取血组比较,双侧髂骨取血移植后髋关节功能 Harris 评分提高,差异有显著性意义(P < 0.01)。说明髓芯减压加自体骨髓单个核细胞移植是治疗早期股骨头缺血性坏死安全有效的方法之一;双侧髂骨取血所分离单个核细胞浓度明显侧高于单侧,且短期随访临床疗效较好。

BACKGROUND： Whether the quality and quantity of blood taken from unilateral and bilateral lilac would affect the concentration of bone marrow mononuclear cells？ OBJECTIVE： To observe the efficacy of mononuclear cells concentration on early femoral head necrosis treated by autologous bone marrow mononuclear cells transplantation. METHODS： The clinical data of 120 patients of 168 hips with femoral head necrosis were retrospectively analyzed, and all the patients were processed with core decompression plus autologous mononuclear cells transplantation. This study included 27 cases （39 hips）, who were taken blood about 200 mL from the unilateral lilac, 29 cases （40 hips）, who were taken blood about 300 mL from the unilateral lilac, 30 cases （42 hips）, who were taken blood about 200 mL from the bilateral lilac, 34 cases （47 hips）, who were taken blood about 300 mL from the bilateral lilac. After the blood was taken from lilac, the bone marrow blood gradient centrifugation was performed by cell segregating, and the mononuclear cells count was observed before and after separation; the mononuclear cells were injected into the bone necrosis area after core decompression. All the patients were followed-up for 12 36 months, and the CT imaging and the Harris score of the hips in the patients before and after treatment were observed. RESULTS AND CONCLUSION： There was no significant difference of the mononuclear cells count between subgroup of 200 mL and 300 mL taken from unilateral and bilateral lilac （P 〉 0.05）, but the mononuclear cells count taken from the bilateral lilac was significantly higher than that taken from the unilateral lilac （P 〈 0.01）. There was no significant difference of the Harris score between groups before transplantation （P 〉 0.05）, and compared with before transplantation, the Harris score and the hip fineness rate was significantly increased after transplantation （P 〈 0.05, P 〈 0.01 ）. In short, core decompression plus autologous bone marrow mononuclear cell transplantation is an easy and safe method for the treatment of early femoral head necrosis. The concentration of mononuclear cells after centrifugation when taken from bilateral lilac is significantly higher than that taken from unilateral lilac, and the better follow-up the higher concentration.