骨髓间充质干细胞移植治疗缺血性脑卒中恢复期患者的疗效观察

Bone marrow mesenchymal stem cells transplantation in the recovery phase of ischemic cerebral stroke patients

目的探讨骨髓间充质干细胞（BMSC）移植治疗缺血性脑卒中恢复期患者的临床疗效。方法选取2011年1月至2012年12月在湖州市第一人民医院康复医学科治疗的缺血性脑卒中恢复期患者为研究对象。18例干细胞组患者均在发生急性缺血性脑卒中后20 d左右在外院接受过BMSC移植治疗,连续3次,间隔时间为7 d,平均疗程（21.0±1.3）d;移植细胞数量为5×107~2×108,移植途径为静脉注射,移植后均未出现明显不良反应。选择同期在康复医学科治疗的18例未接受过干细胞移植的缺血性脑卒中恢复期患者为对照组。两组患者均给予常规药物治疗以及3个月康复治疗。两组患者在康复治疗前后均使用功能独立性评定（FIM）量表以及日常生活能力（ADL）量表进行评分。结果康复治疗前,干细胞组和对照组患者FIM和ADL评分差异均无统计学意义（t=1.21和1.17,P均〉0.05）。干细胞组患者康复治疗后FIM和ADL评分均高于康复治疗前,差异均有统计学意义（t=3.42和3.75,P均〈0.05）;对照组患者康复治疗后FIM和ADL评分均高于康复治疗前,差异均有统计学意义（t=2.87和3.24,P均〈0.05）。康复治疗后,两组患者FIM和ADL评分差异均无统计学意义（t=2.68和2.94,P均〉0.05）。结论 BMSC移植治疗缺血性脑卒中恢复期患者短期内观察疗效不确切。

Objective To study the clinical outcomes of bone marrow mesenchymal stem cells（ BMSCs） transplantation in the recovery phase of ischemic cerebral stroke patients.Method A total of 36 patients diagnosed as ischemic cerebral stroke were included in this study at the clinic of rehabilitation medicine of Huzhou First People＇s Hospital from the January 2011 to the December 2012.The patients were divided into 2 groups：therapy group（ n=18）,all received BMSCs transplantation in the others hospital after the stroke;the non-therapy group：all have not received BMSCs transplantation patients.Patients were provided with comprehensive rehabilitation and drug treatment in two groups.The time of treatment is 3 months.And they were evaluated by FIM and ADL before and after treatment.Results The scores of two groups after treatment are no difference（ t=1.21,t=1.17,P〈0.05）.The scores of FIM and ADL after treatment are higher than before treatment in the therapy group（ t=3.42,t=3.75,P〈0.05） and the non-therapy group（ t=2.87,t=3.24,P〈0.05）,respectively.There are no difference in the two groups after treatment（ t=2.68,t=2.94,P〈0.05）.Conclusion BMSCs transplantation has no significant therapeutic effect on the recovery phase of ischemic cerebral stroke patients in short-term observation.