腰椎穿刺移植自体骨髓间充质干细胞治疗脑梗死后遗症6例

背景：骨髓间充质干细胞具有多向分化潜能，而且取材方便，扩增迅速，免疫原性低，在移植过程避免了免疫排斥等反应，是治疗脑梗死等神经系统疾病的理想种子细胞。目的：探讨自体骨髓间充质干细胞培养后经腰穿治疗脑梗死后遗症的安全性、可行性及疗效。方法：6例脑梗死后遗症患者进行自体骨髓间充质干细胞移植，骨穿采集自体骨髓单个核细胞，体外分离培养骨髓间充质干细胞4 d后经腰椎穿刺移植蛛网膜下腔，移植后观察疗效及并发症。结果与结论：培养后骨髓间充质干细胞数量明显增多，患者手术前后肌力和NIHSS评分通过统计分析有显著性差异(P < 0.05)，总体症状改善较术前有明显改善；移植后无严重不良事件发生。结果提示，自体骨髓间充质干细胞培养后移植治疗可使脑梗死后遗症患者症状明显改善，治疗安全有效且不良反应小。

Autologous bone marrow mesenchymal stem cell transplantation via lumbar puncture in the treatment of cerebral infarction sequelae in 6 cases

BACKGROUND: Bone marrow mesenchymal stem cells have multi-directional differentiation potential, and are easily, rapidly expanded, low immunogenicity, avoid immunological rejection in the transplant process, are ideal seed cells in the treatment of neurological diseases such as cerebral infarction. OBJECTIVE: To explore the safety, feasibility and efficacy of autologous bone marrow mesenchymal stem cell after culture transplantation via lumbar puncture in treatment of cerebral infarction. METHODS: A total of 6 cases of sequelae of cerebral infarction received autologous bone marrow mesenchymal stem cell transplantation. Autologous bone marrow mononuclear cells were collected by bone puncture. Bone marrow mesenchymal stem cells in vitro cultured 4 days after transplantation by lumbar puncture in the subarachnoid space. The efficacy and complications were observed after transplantation.RESULTS AND CONCLUSION: Numbers of BMSCs were significantly increased after culture. There were significant differences in NIHSS scores and muscle strength of patients before and after operation (P < 0.05) and the overall improvement of symptoms were improved significantly. After transplantation, there were no serious adverse events. The results suggest that autologous bone marrow mesenchymal stem cell transplantation can significantly improve symptoms in patients with cerebral infarction sequelae; treatment is safe, effective and low side effects.