自体骨髓间充质干细胞移植脑性瘫痪儿童运动功能的评价

背景：干细胞具有修复和替代受损脑组织的潜力,被认为是一种新的治疗小儿脑性瘫痪的方法。目的：用粗大运动功能测试量表88项及精细运动功能评估量表45项评价自体骨髓间充质干细胞移植对脑性瘫痪患儿运动功能的改善情况。方法：对20例脑性瘫痪患儿进行自体骨髓间充质干细胞移植治疗,用粗大运动功能测试量表88项及精细运动功能评估量表45项对治疗前及治疗后1,3,6 个月时患儿的粗大及精细运动功能进行评估。结果与结论：随访过程中有3例患儿失访。顺利完成研究的17例患儿治疗后 1,3,6个月的粗大运动功能测试量表88项总分及A(卧位与翻身)、B(坐位)、C(爬与跪)功能区得分,精细运动功能评估量表45项总分及B(上肢关节活动能力)、C(抓握能力)功能区得分均较移植前显著提高(P < 0.05),以治疗后1个月的提升速度最显著,且未见明显不良反应。提示自体骨髓间充质干细胞移植可改善脑性瘫痪患儿的粗大运动和精细运动功能,对治疗小儿脑性瘫痪是安全、有效、可行的。

Effect evaluation of autologous bone marrow mesenchymal stem cell transplantation on motor function in children with cerebral palsy

BACKGROUND:Cerebral palsy is described as a group of permanent disorders affecting motor development and posture, resulting in activity limitation. Although there are many kinds of functional therapy programs for cerebral palsy, their effects are limited. Stem cell based therapy, a new prospective therapy for central nervous system disorders, has the potential to repair and replace damaged brain tissue, and alleviate neurological deficits and motor function in cerebral palsy.OBJECTIVE:Using Gross Motor Function Measure-88 (GMFM88) and Fine Motor Function Measure-45 (FMFM45) scale to evaluate the effect of autologous bone marrow mesenchymal stem cell transplantation on motor function in children with cerebral palsy.METHODS:Twenty cerebral palsy children received autologous bone marrow mesenchymal stem cell transplantation and their motor functions were measured using GMFM88 scale and FMFM45 at baseline (the day before treatment) and 1, 3 and 6 months after treatment.RESULTS AND CONCLUSION:Seventeen subjects successfully accomplished the clinical study. Results of statistical analysis by SPSS13.0 software showed that (1) The A, B, C functional area scores and total score of GMFM88 increased significantly at 1, 3 and 6 months after bone marrow mesenchymal stem cell transplantation than that at baseline (P < 0.05). (2) The B, C functional area scores and total score of FMFM45 increased significantly at 1, 3 and 6 months after bone marrow mesenchymal stem cell transplantation than that at baseline (P < 0.05). During the present study period, no events had happened. Bone marrow mesenchymal stem cell transplantation is a safe, effective and feasible method to treat cerebral palsy patients. The gross and fine motor function was most rapidly improved in 1 month after the therapy and it could be continuously improved within 6 months after the therapy.