自体骨髓间充质干细胞移植与康复锻炼对小儿脑瘫患者粗大运动功能影响分析

目的观察自体骨髓间充质干细胞移植同康复锻炼治疗对脑瘫患儿粗大运动功能改善的临床疗效。方法对40例脑性瘫痪患儿分A、B两组,每组20例。A组进行骨髓间充质干细胞移植治疗,B组进行单纯康复锻炼治疗。对两组患儿治疗前、后及3、6个月进行粗大运动功能评估,比较两组患儿粗大运动功能进步程度。结果干细胞组17例受试者顺利完成临床研究,康复组18例完成临床研究。A组术后1个月、3个月及6个月的GMFM总分及A、B、C功能区得分均较移植前显著提高(P<0.05);B组患儿接受康复锻炼治疗在治疗前,治疗后1个月,治疗后3个月及6个月均接受综合测评,结果显示该组患儿康复锻炼3个月后患儿粗大运动可有明显改善(P<0.05),二者比较干细胞移植组患儿粗大运动功能提升分值较单纯康复锻炼组明显。结论 BM-MSCs移植治疗小儿脑瘫是安全、有效、可行的,可改善脑瘫患者的粗大运动功能,疗效以术后一个月改善最明显,术后6个月仍会继续改善脑瘫患儿粗大运动功能。干细胞移植后行康复锻炼相比单纯康复锻炼对脑瘫患儿粗大运动功能提升效果更明显,二者具有叠加作用。

The effect of autologous bone marrow mesenchymal stem cell transplantation and rehabilitation exercise therapy on gross motor function in children with cerebral palsy

【Objective】 To observe the effect of autologous bone marrow mesenchymal stem cell transplantation and rehabilitation exercise therapy on gross motor function in children with cerebral palsy.【Methods】 40 cases of children with cerebral palsy separate into A,B groups,each group of 20 patients.A group using autologous bone marrow mesenchymal stem cells transplantation therapy,B group rehabilitation exercises alone.Two groups of children giving gross motor function test before and after treatment and 3 and 6 months compared the degree of improvement.【Results】 The stem cell group 17 patients successful completion of clinical studies;Clinical rehabilitation group,18 patients completed the study.A group after 1 month,3 months and 6 months of GMFM total score and the A,B,C compared with pre-transplant functional area score significantly increased(P <0.01);Group B patients received rehabilitation exercise therapy before treatment,after treatment,1 month,3 months and 6 months,underwent comprehensive evaluation of the results show that the group of children with rehabilitation exercises 3 children with gross motor can be significantly improved(P <0.05);Compared with rehabilitation exercise therapy group,the stem cell transplantation group obvious enhanced the gross motor function than rehabilitation exercise therapy.【Conclusion】 BM-MSCs transplantation for treatment of children with cerebral palsy is safe,effective,feasible and can improve gross motor function in patients with cerebral palsy,the effect most significant improvement after one month.After treatment six months will continue to improve children with cerebral plasy gross motor function.Compared to rehabilitation exercises,stem cell transplantation is more effective,but both with superimposition.