自体骨髓间充质干细胞移植在严重脑外伤后遗症患者中的应用

The application of autologous bone marrow mesenchymal stem cell transplantation on the sequelae of patients with severe traumatic brain injury

目的研究自体骨髓间充质干细胞移植方案,治疗严重脑外伤后遗症患者的可行性及临床效果。方法回顾性分析2011年3月-2013年10月本院26例严重脑外伤后遗症患者,依据患者个人意愿选择治疗方案,分为干细胞移植治疗组(n=14)和常规治疗对照组(n=12)。结果干细胞移植患者术后平均住院10 d。为期1个月的治疗结束6个月后,对所有患者功能独立性方面进行评分和对比研究。结果表明,干细胞移植组患者在生活自理能力、活动能力、行动能力、理解交流能力、社会认知能力及总分方面较治疗前差异有统计学意义(P<0.05)。移植组在治疗后1个月、3个月、6个月时NIHSS评分差异有统计学意义(P<0.05),而对照组无此效果。结论自体骨髓间充质干细胞移植术在治疗严重脑外伤后遗症方面有较好的临床疗效,在其他脑损伤,如脑缺血、脑出血等脑内伤方面可能同样有效。

Objective To study the feasibility and clinical effect of the transplantation of mesenchymal stem cell from autologous bone marrow in the treatment of patients with sequelae of severe traumatic brain injury. Methods A retrospective analysis was done on 26 cases of patients with sequelae of severe traumatic brain injury in our hospital during the period of March,2011 to October,2013. According to the individual wish of each patient on treatment option,they were divided into treatment group with stem cell transplantation（ n = 14） and control group with conventional treatment（ n = 12）. Results The mean postoperative days staying in hospital were about 10 days after stem cell transplantation. At the end of 6 months after treatment,all patients＇ functional independence scores and comparative studies were evaluated. The results showed that after stem cell transplant,patients＇ daily living,mobility,mobility,communication skills before understanding,social cognition and total score were significantly improved compared to the conventional treatment,the difference had statistical significance（ P〈0. 05）. NIHSS scores of patients in transplantation group at 3 and 6 months after treatment were markedly improved,the difference had statistical significance（ P〈0. 05）,while no such effect on control group. Conclusion Autologous bone marrow mesenchymal stem cell transplantation got better clinical efficacy in the treatment of sequelae in severe traumatic brain injuries. It may be also equally effective on other brain damage,such as cerebral ischemia,cerebral hemorrhage and other aspects of brain injuries.