脐血间充质干细胞移植治疗肾性贫血:热点与问题

Umbilical cord blood mesenchymal stem cell transplantation for the treatment of renal anemia: Hot spots and issues

背景:脐血作为造血干细胞来源已成为研究热点,脐血输注辅助治疗已在国内使用,临床已将脐血输注用于纠正尿毒症患者的肾性贫血。目的:评价脐血间充质干细胞移植治疗肾性贫血的有效性及安全性,并与不同来源的间充质干细胞不同移植途径对肾脏病的治疗作用进行比较。方法:回顾分析2010年1月至2012年12月在河南省红十字血液中心门诊部收治的6例肾性贫血患者,实验经医学伦理委员会批准,6例患者对治疗方案均知情同意,产妇及其家属均签署知情同意书,以无菌塑料采血袋密闭式采集足月新生儿脐血80-140mL,分离获得的人脐血间质干细胞通过手背浅静脉输注入肾性贫血患者体内,细胞数≥1×108/份,2份/次,间隔4d后再次输注,共3次,观察治疗前后血红细胞压积、血红蛋白、尿中红细胞、肾血流量变化。结果与结论:治疗前后患者的血红蛋白、血红细胞压积、尿中红细胞、肾血流量显著增加(P<0.05)。经手背浅静脉多份输注脐血间充质干细胞,方法简便且安全有效,是治疗肾性贫血的一种新方法。但此次临床研究设计为自身前后对照,数据结论具有一定局限性,需进一步验证。

BACKGROUND： Umbilical cord blood as a source of hematopoietic stem cells has become a hot topic. Adjuvant therapy of umbilical cord blood transfusion has been used in China to correct renal anemia of uremia patients. OBJECTIVE： To evaluate the efficacy and safety of umbilical cord blood mesenchymal stem cells in the treatment of renal anemia, and to compare with the effects of different sources of mesenchymal stem cells with different transplantation methods on the treatment of kidney diseases. METHODS： A retrospective analysis was conducted on six renal anemia patients in the Department of Outpatient, Henan Red Cross Blood Center between January 2010 and December 2012. The experiment was approved by Medical Ethics Committee, six patients were informed consent for treatment programs, and parturients and their families have signed the informed consent. The newborns umbilical cord blood of 80-140 mL were collected with closed sterile plastic blood bags, and then the separated umbilical cord blood mesenchymal stem cells were transfused into the renal anemia patients through the superficial vein in the back of the hand with the number of ≥1×10 8 /copy, two copies per time, and re-transfused after 4 days, a total of three times. The blood hematocrit, hemoglobin, red blood cells in urine, renal blood flow changes were observed before and after treatment. RESULTS AND CONCLUSION： The hemoglobin, blood hematocrit, red blood cells in urine and renal blood flow were significantly increased before and after treatment （P〈0.05）. Transfusion of multiple copies of umbilical cord blood mesenchymal stem cells through the superficial vein in the back of the hand is convenient and safe, which is considered as a new method for the treatment of renal anemia. But there are certain limitation in the data and the conclusion as the clinical research was designed as self-control, so further confirm is needed.