采用自体骨髓间充质干细胞修复股骨头坏死（Ⅰ、Ⅱ期）的临床研究

Clinical study of autologous bone marrow mesenchymal stem cells in repairing osteonecrosis （ stage I and II）

目的研究采用自体骨髓间充质干细胞修复股骨头缺血性坏死改善和治疗效果。方法运用自体骨髓间充质干细胞治疗56例髋成人股骨头缺血性坏死患者。采取患者髂后上棘骨髓液200mL，分离自体骨髓间充质干细胞并制成悬液20-30mL，在数字减影技术（DSA）透视下超选择注入股骨头滋养供血动脉内，行自体骨髓间充质干细胞移植。移植术后DSA观察新血管形成，影像学方法观察股骨头形态学变化。结果6个月后随访发现接受自体骨髓间充质干细胞移植治疗的56例患者，髋关节疼痛缓解的52例（86．6％），髋关节功能改善的50例（82．3％），行走距离延长者51例（85．7％）；DSA检查显示供血动脉较移植之前明显增多、增粗、血流速度增快。12—24个月后股骨头区域的骨质明显获得改善（100．0％）。结论骨髓间充质干细胞移植方法简便，安全有效，能够有效的治疗Ⅰ期和Ⅱ期的股骨头缺血性坏死。

Objective To study the effect of autologous bone marrow mesenchymal stem cells in the treatment of osteonecrosis. Methods 56 cases of osteonecrosis of femeral head （ONFH） were treated with autologous bone marrow mesenchymal stem cells. DSA observed neovascularization after transplantation, morphological changes of femoral head were observed by imaging method. Results Of the 30 patients who underwent autologous bone marrow stem cell transplantation,86.6% had resuscitation of hip pain,23.3 % had improved hip function, and 85.7% had walking distance. Examination showed that the arterial artery was significantly increased before transplantation, thickening,faster blood flow. The femoral head area of the bone was significantly improved （ 100.0% ） after 12 - 24 months. Conclusion The method of transplantation of bone marrow mesenchymal stem cells is simple, safe and effective. It is effective for stage I and II of the avascular necrosis of the femoral head.