脐血间充质干细胞移植治疗多系统萎缩20例

目的:观察脐血间充质干细胞移植治疗帕金森病患者神经功能的效果.方法:选择2008-01/12北京和众华信治疗中心收治的帕金森病患者30例,均经过英国皇家医师学会帕金森病诊断与管理指南的帕金森病诊断标准确诊,男19例,女11例,年龄45～66岁,平均年龄58岁,Hoehn-Yahr分级为Ⅱ～Ⅳ级,患者对治疗均签署知情同意书,治疗方案经医院医学伦理委员会批准.所有患者均住院治疗,第1周进行常规检查,30例患者血、尿、便常规、肝肾功能、多项肿瘤标记物、胸片等均正常.自第2周起患者应用脐带血间充质干细胞进行鞘内注射移植治疗,以第3,4腰椎间隙为穿刺点,缓慢注入地塞米松2 mg,取脐血间充质干细胞注射液5 mL(干细胞数500万),在10 min内缓慢注入蛛网膜下腔,1次/周,4次为1个疗程,共治疗1个疗程.采用帕金森病统一评分量表对患者移植前后神经功能进行评定,分值越高表示神经功能缺损越严重.结果:30例患者均进入结果分析,中途无脱落.与移植前比较,30例患者移植后3个月帕金森病统一评分量表分值均明显降低(P＜0.01),患者震颤、强直、运动迟缓、姿势不稳等临床症状均得到明显改善,均未出现移植物抗宿主病.结论:脐血间充质干细胞移植可以一定程度地改善帕金森病患者的临床症状,提高患者生活质量.

Umbilical cord blood mesenchymal stem cell transplantation in 20 patients with multiple system atrophy

OBJECTIVE:To observe the outcomes of umbilical cord blood mesenchymal stem call transplantation for treating neural function of multiple system atrophy (MSA) patients.METHODS:A total of 20 MSA patients were selected at the Beijing Wu Stem Cells Medical Center from January to October 2008.All patients received treatment of vessel distention,anti-free radical,trophic nerve and call membrane stabilization,as well as umbilical cord blood mesenchymal stem call transplantation via intrathecal injection.Patients at left-lateral position,and body bent at hips,knees and necks.Acupuncture was conducted at the space of lumbar vertebra 3 and 4.Following local anesthesia,No.9 needle was directly pricked into the subarachnoid cavity.2 mg dexamethasone was slowly infused,and 5 mL (5×106 stem cells) umbilical cord blood mesenchymal stern call injection was obtained and slowly infused into the subarachnoid cavity within 10 minutes,once per week,four times as a course,totally one course.We adopted Unified Multiple System Atrophy Rating Scale (UMSARS) to evaluate those MSA patients.The higher score represented a severe pathogenetic condition.RESULTS:Compared with pretransplantation,the UMSARS score was significantly decreased in 20 patients 4 weeks follwing transplantation (P ＜ 0.01).After the treatment,patient's clinical symptoms such as slow movement,balance disturbance,orthostatic hypotension,urinary and bowel disorders had full obvious improvement.Graft versus host disease was not found.CONCLUSION:It is indicated that mesenchymal stem call transplantation is effective,can partly improve MSA patients' clinical symptoms,and improve patients' life quality.