富集自体骨髓干细胞移植与髓芯减压治疗缺血性股骨头坏死患者血清成纤维细胞生长因子2、缺氧诱导因子1α、血管内皮生长因子的变化

背景：缺血性股骨头坏死以股骨头血液供应不足为主要病因。髓芯减压术属于临床常用治疗手段，有研究发现采用自体骨髓干细胞移植能较好地改善髋关节功能，二者联合应用可促使患者尽早恢复。 目的：观察自体骨髓干细胞移植联合髓芯减压治疗早期缺血性股骨头坏死的疗效以及血清成纤维细胞生长因子2、缺氧诱导因子1α、血管内皮生长因子水平。 方法：选取2016年1月至2018年1月收治的62例早期缺血性股骨头坏死患者进行研究，参照随机数字表法分为研究组(n=31)和对照组(n=31)，对照组给予细针多孔道髓芯减压术治疗，研究组在对照组基础上联合自体骨髓干细胞移植治疗，观察两组患者治疗前后Harris评分、目测类比评分、血清成纤维细胞生长因子2、缺氧诱导因子1α、血管内皮生长因子水平及不良反应发生情况。 结果与结论：①两组患者治疗后3，6，12个月Harris评分均高于治疗前(P < 0.05)，研究组高于对照组(P < 0.05)；②两组患者治疗后3，6，12个月目测类比评分均低于治疗前(P < 0.05)，研究组治疗后3，6个月目测类比评分低于对照组(P < 0.05)；③两组患者治疗后3，6，12个月血清成纤维细胞生长因子2水平高于治疗前(P < 0.05)，研究组高于对照组(P < 0.05)；缺氧诱导因子1α、血管内皮生长因子水平明显低于治疗前(P < 0.05)，研究组低于对照组(P < 0.05)；④两组患者治疗后不良反应发生率比较差异无显著性意义(P > 0.05)；⑤结果表明自体骨髓干细胞移植联合髓芯减压治疗早期缺血性股骨头坏死，可有效改善髋关节功能，促进股骨头坏死区修复，减轻患者疼痛，提高成纤维细胞生长因子2水平，降低缺氧诱导因子1α、血管内皮生长因子水平。 ORCID: 0000-0001-9884-7530(张景义) 中国组织工程研究杂志出版内容重点：干细胞；骨髓干细胞；造血干细胞；脂肪干细胞；肿瘤干细胞；胚胎干细胞；脐带脐血干细胞；干细胞诱导；干细胞分化；组织工程

Changes in serum levels of fibroblast growth factor-2, hypoxia-inducible factor-1alpha and vascular endothelial growth factor in patients with avascular necrosis of femoral head treated by enriched autologous bone marrow stem cell transplantation combined

BACKGROUND:Avascular necrosis of the femoral head is mainly caused by insufficient blood supply of the femoral head.Core decompression is a common clinical treatment,enriched autologous bone marrow stem cell transplantation can improve hip function,and combined application can promote early recovery of patients.OBJECTIVE:To investigate the therapeutic effects of enriched autologous bone marrow stem cell transplantation combined with core decompression on serum levels of fibroblast growth factor-2,hypoxia-inducible factor-1αand vascular endothelial growth factor in patients with early avascular necrosis of femoral head.METHODS:Sixty-two cases of early avascular necrosis of femoral head treated from January 2016 to January 2018 were selected,and were divided into study group(n=31)and control group(n=31)according to the random number table method.The control group was treated with fine-needle porous-channel core pulp decompression,while the study group was treated with enriched autologous bone marrow stem cell transplantation on the basis of the control group.Harris score,Visual Analogue Scale score,serum fibroblast growth factor-2,hypoxia-inducible factor-1αand vascular endothelial growth factor levels and adverse reactions were observed before and after treatment.RESULTS AND CONCLUSION:(1)The Harris scores at 3,6 and 12 months after treatment in the two groups were higher than those before treatment(P<0.05),and those in the study group were higher than those in the control group(P<0.05).(2)The Visual Analogue Scale scores at 3,6 and 12 months after treatment in the two groups were lower than those before treatment(P<0.05),and the scores at 3 and 6 months after treatment in the study group were lower than those in the control group(P<0.05).(3)The levels of serum fibroblast growth factor-2 at 3,6 and 12 months in the two groups were higher than those before treatment,and the scores in the study group were higher than those in the control group(P<0.05).The levels of hypoxia-inducible factor-1αand vascular endothelial growth factor in the two groups were significantly lower than those before treatment(P<0.05),and those in the study group were lower than those in the control group(P<0.05).(4)There was no significant difference in the incidence of adverse reactions between two groups after treatment(P>0.05).(5)These results suggest that enriched autologous bone marrow stem cell transplantation combined with core decompression in the treatment of early avascular necrosis of femoral head can effectively improve hip joint function,promote the repair of femoral head necrosis area,alleviate pain,increase the level of fibroblast growth factor-2,and reduce the levels of hypoxia-inducible factor-1αand vascular endothelial growth factor.