年龄对嗅鞘细胞移植治疗脊髓损伤疗效的影响

Age Influnces on Recovery Outcome of Spinal Cord Injury Treated by Intraspinal Transplantation of OECs

为探讨年龄因素对嗅鞘细胞移植治疗脊髓损伤临床疗效的影响 ,用嗅鞘细胞 (OECs)移植到脊髓损伤部位上下处的方法 ,共治疗 1 71例脊髓损伤 0 .5～ 1 8年的患者。患者年龄 2 .5～ 64岁 (平均 3 4.9岁 ) ,按年龄分为 5组 :≤ 2 0岁 9例 ,2 1～ 3 0岁 5 4例 ,3 1～ 40岁 60例 ,41～ 5 0岁 3 4例 ,≥ 5 1岁 1 4例。嗅鞘细胞移植后 2～ 8周随访 ,根据美国脊髓损伤学会 (ASIA)脊髓损伤神经功能分类国际标准评价。结果 :1 71例患者的脊髓功能均有部分恢复 ,除 5 1岁以上组的痛觉恢复与其他年龄组 (除 2 1～ 3 0岁组 )比较有显著性差异 (P <0 .0 5 )外 ,各年龄组的运动和触觉改善比较均无显著性差异。结果提示 :嗅鞘细胞移植能改善所有年龄段脊髓晚期损伤患者的神经功能 ,除老年组痛觉恢复较好外 ,年龄因素对运动和触觉的近期效果无明显影响 。

Objective: To compare the recovery outcome of patients among different ages with spinal cord injuries(SCI) treated by intraspinal transplantation of olfactory ensheathing cells(OECs). Methods: Olfactory bulbs were obtained and trypsinized to be single OECs; which were cultured for about 2 weeks, then transplanted into the upper and lower sites between the injury and the normal spinal cord. 171 patients with the spinal cord injury were treated from half a year to eighteen years after trauma. There were 139 males and 32 females with ages ranging from 2.5 to 64 years (mean 34.9 years). They were divided into 5 groups, 9 patients in the group of less than 20 years old age, 54 in the group of 21 to 30 years, 60 in the group of 31 to 40 years, 34 in the group of 41 to 50 years and 14 in the group of more than 51 years. The spinal cord function was assessed by using the American Spinal Injury Association (ASIA) Classification System before and 2 to 8 weeks after operation. Statistical significance levels were calculated using a one way ANOVA paired T test. Results: The motor score of ASIA motor and sensory scale increased by 5.2±4.8, 8.6± 8.0 , 8.3±8.8, 5.7±7.3 and 8.2±7.6 in the 5 groups after operation respectively. Light touch score increased by 13.9±8.1, 15.5±14.3, 12.0±14.4, 14.1 ±18.5 and 24.8±25.3 respectively. Pin prick score increased by 11.1±7.9, 17.2±14.3, 13.2±11.8, 13.6±13.9 and 25.4±24.3 respectively. Pin prick in over 51 years groups better than other groups( P < 0.05) except 21～30 years group. Conclusion: OECs transplantation can improve the neurological function of the spinal cord of all patients following SCI regardless of age. The age of injury does not affect ASIA Score for motor and light touch except better recovery for pin prick in over 51 years group. However, further research into the long term outcome of the treatment will be required.