人脐血单个核细胞移植治疗急性一氧化碳中毒后迟发脑病1年随访

背景：研究报道在特定的体内外环境下，脐血间充质干细胞能够诱导分化成为包括神经干细胞在内的多种组织细胞。目的：评价人脐血单个核细胞经腰穿途径移植后治疗急性一氧化碳中毒后迟发性脑病的疗效及安全性。 方法：一氧化碳中毒后迟发性脑病患者60例随机分为2组。对照组给予高压氧及药物治疗；治疗组采用鞘内注射法将经密度梯度离心法分离出的人脐血单个核细胞移植到一氧化碳中毒性脑病患者的蛛网膜下腔，余治疗方法同对照组。分别于人脐血单个核细胞移植前、移植后3，9，12个月对患者进行简易精神状态检查法、改良Asworth肌肉痉挛程度分级及日常生活量表评分检查；比较两组患者MRI变化；同时对随诊患者行胸片、心电图及血生化检查，客观评价人脐血单个核细胞移植的安全性。结果与结论：人脐血单个核细胞移植3，9，12个月，治疗组Asworth肌肉痉挛程度分级评分均显著低于对照组(P=0.032)；移植后9，12个月简易智力状况检查法及日常生活量表评分均显著高于对照组(P < 0.05)；两组患者神经功能在各时间点的变化趋势相似。人脐血单个核细胞移植后12个月MRI检查结果显示，治疗组患者MRI改善程度较对照组明显。提示鞘内注射移植人脐血单个核细胞治疗一氧化碳中毒后迟发脑病疗效优于高压氧治疗。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；组织工程全文链接：

Therapeutic efficacy of umbilical cord blood mononuclear cells on delayed encephalopathy after acute carbon monoxide poisoning: a 1-year follow-up

BACKGROUND: Under a specific environment in vivo and in vitro, umbilical cord blood mesenchymal stem cells can be induced to differentiate into various tissues and cells, including neural stem cells.OBJECTIVE: To investigate the safety and efficacy of human umbilical cord blood mononuclear cell transplantation via lumbar puncture in the treatment of delayed encephalopathy after acute carbon monoxide poisoning.METHODS: Sixty patients with delayed encephalopathy after acute carbon monoxide poisoning were randomly divided into two groups: treatment group undergoing intrathecal injection of human umbilical cord blood mononuclear cells that were isolated using density gradient centrifugation method into the subarachnoid space of patients with delayed encephalopathy induced by acute carbon monoxide poisoning; control group undergoing hyperbaric oxygen and drug treatments. Mini-mental state examination (MMSE), improved Asworth muscle spasm degree and activity of daily living scale (ADL) were assessed in patients prior to and 3, 9, 12 months after  cell transplantation. The MRI changes of the two groups were compared. Meanwhile, lung X-ray, electrocardiogram and blood biochemical test were also measured to evaluate the safety of human umbilical cord blood mononuclear cell transplantation.RESULTS AND CONCLUSION: At 3, 9, 12 month after cell transplantation, the Asworth muscle spasm degree was significantly lower in the treatment group than the control group (P=0.032). At 9 and 12 months after cell transplantation, scores on MMSE and ADL were also higher in the treatment group than the control group (P < 0.05). Change of neurological functions in patients from two groups showed a similar tendency. At 12 months after cell transplantation, MRI examination showed better outcomes in the treatment group than the control group. These findings indicate that intrathecal injection of human umbilical cord blood mononuclear cells is superior to hyperbaric oxygen in the treatment of delayed encephalopathy induced by acute carbon monoxide poisoning