自体骨髓干细胞移植治疗脊髓损伤420例

目的：总结分析骨髓干细胞移植治疗脊髓损伤的效果。 方法：2003-09/2008-04解放军第四六三医院神经外科细胞治疗康复中心行干细胞移植的脊髓损伤患者420例，按病情分为2组：完全性脊髓损伤组42例，不完全性脊髓损伤组378例，两组患者在性别、年龄、受伤时间、损伤部位、损伤原因等方面比较差异无显著性意义(P > 0.05)。两组首先通过手术或立体定向的方法把干细胞直接移植在脊髓损伤部位，然后再根据患者病情经腰穿途径或经静脉途径移植，每次移植间隔为1周，干细胞移植量为(2~3)个×102/kg。移植过程中为促进干细胞的生长和分化，根据患者病情及身体状况给予相应的康复功能锻炼。 结果：与入院时比较，骨髓干细胞移植1，3，12个月后，不完全性脊髓损伤患者针刺觉评分、轻触觉评分、运动评分均有明显改善(P < 0.05或0.01)，完全性脊髓损伤患者针刺觉评分、轻触觉评分、运动评分均无明显变化(P > 0.05)，两组残损分级均无明显改善(P > 0.05)。 结论：骨髓干细胞移植治疗脊髓损伤有效可行。

Autologous bone marrow stem cell transplantation for spinal cord injury in 420 cases

OBJECTIVE: To summarize and analyze the effect of bone marrow stem cell transplantation for spinal cord injury treatment. METHODS: A total of 420 patients with spinal cord injury who received the stem cell therapy in the Cell Treatment and Rehabilitation Center at Department of Neurosurgery in the 463 Hospital of Chinese PLA between September 2003 and April 2008 were enrolled in the experiment. They were divided into two groups according to disease condition: 42 cases in complete spinal cord injury group and 378 cases in incomplete spinal cord injury group. There was no significant difference between two groups in gender, age, injured time, injured part, and injure reason (P > 0.05). The stem cells were directly transplanted into spinal cord injured parts by the surgery or the stereotactic method in all patients in the two groups. Then the stem cell transplantation was performed again by lumber puncture or vein way according to the disease condition of patients for every one week. The stem cell number was (2-3) ×102/kg. All the patients were received corresponding recovery function exercise according to the disease condition for promoting the stem cell growth and differentiation. RESULTS: At the 1, 3, and 12months after bone marrow stem cell transplantation, the pin prick score, light touch score, and motor score of the patients in the incomplete spinal cord injury group had the obvious improvement compared with those on admission (P < 0.05 or 0.01), while the pin prick score, light touch score and motor score, of the patients in the complete spinal cord injury group had no obvious change. There was no obvious improvement in impairment classification in the two group (P > 0.05). CONCLUSION: It is effective and feasible for bone marrow stem cell transplantation to treat spinal cord injury.