神经干细胞移植治疗颅脑损伤后遗症:最佳时机选择

Neural stem cell transplantation for sequela of traumatic brain injury: the best timing for treatment

背景:神经干细胞移植为治疗颅脑损伤后遗症提供了重要思路,但是在治疗时机选择方面,尚无明确的定论。目的:探讨神经干细胞移植治疗颅脑损伤后遗症的临床效果及其最佳治疗时机。方法:选择178例颅脑损伤后遗症患者,均接受神经干细胞移植治疗,按照治疗时机分为损伤后6个月以内组(60例)、损伤后6-12个月组(59例)、损伤后12个月以上组(59例),分别在损伤后6个月以内、损伤后6-12个月、损伤后12个月以上进行神经干细胞移植治疗。记录3组患者的临床症状改善情况和功能独立性评定量表评分。结果与结论:(1)损伤后6个月以内组的治疗总有效率显著高于损伤后6-12个月组和损伤后12个月以上组,差异有显著性意义(P<0.05)。(2)与移植前比较,3组患者的功能独立性评定量表评分显著提高(P<0.05);第4次移植后3个月,损伤后6个月以内组功能独立性评定量表评分显著高于其他两组。(3)神经干细胞移植治疗后,损伤后6个月以内组不良反应发生率显著低于其他两组(P<0.05)。(4)结果表明不同时机移植神经干细胞均可以获得一定的效果,其损伤后6个月以内是临床最佳治疗时机。

BACKGROUND： Neural stem cell transplantation provides an important way to treat sequela of traumatic brain injury, but the timing for treatment is inconclusive. OBJECTIVE： To explore the clinical effect of neural stem cell transplantation in the treatment of sequela of traumatic brain injury and the choice of the best treatment time. METHODS： Totally 178 patients with sequela of traumatic brain injury who underwent neural stem cell transplantation were divided into three groups as per the timing for neural stem cell transplantation： group A（with 6 months after injury, n=60）, group B（6-12 months after injury, n=59）, and group C（over 12 months after injury, n=59）. Improvement in clinical symptoms and scores on function independent measure（FIM） were recorded and compared in the three groups. RESULTS AND CONCLUSION： The total effective rate of group A was significantly higher than that in groups B and C（P〈0.05）. FIM scores were significantly improved in the three groups after cell transplantation（P〈0.05）. At 3 months after the fourth transplantation, the FIM score in the group A was significantly higher than that in the other two groups, and the incidence of adverse reactions in the group A was significantly lower than that in the other two groups（P〈0.05）. These findings indicate that neural stem cell transplantation at different timing can all harvest certain clinical effects, but the best timing for neural stem cell transplantation is within 6 months after injury.