脐带间充质干细胞鞘内移植治疗不完全性颈髓损伤的疗效和安全性

 目的 评估脐带间充质干细胞(umbilical cord mesenchymal stem cells, UC-MSCs)移植治疗不完全性颈髓损伤的疗效和安全性。方法 对39例不完全性颈髓损伤患者进行4次鞘内UC-MSCs移植术, 术前及术后6个月应用美国脊髓损伤协会(American Spinal Injury Association, ASIA)制定的神经功能评分标准、日常生活活动能力评分标准(Barthel指数评分),对患者移植前后运动、感觉功能、肌张力及日常生活活动能力的改善情况进行评估。记录治疗期间的不良反应。结果 干细胞移植后6个月,患者感觉、运动功能、肌张力及日常生活活动能力,与术前相比均具有统计学差异,其中运动功能方面改善最为明显,ASIA评分治疗前61±22,治疗后70±18。均未发生术区感染、脑脊液漏、中枢神经系统感染等并发症,但有6例(15.4%)于术后24 h内出现发热,3例(7.7%)术后出现低颅压症状,2例(5.1%)术后出现腰部及下肢疼痛、麻胀感。结论 UC-MSCs鞘内移植可以改善不完全性颈髓损伤患者的感觉、运动、二便及自主神经功能等多方面的神经缺失症状,疗效较理想且安全。

Effect and safety of umbilical cord mesenchymal stem cell transplantation in treatment of incomplete cervical spinal cord injury

Objective To study the therapeutic effect of umbilical cord mesenchymal stem cell (UC-MSC) transplantation on incomplete cervical spinal cord injury. Methods 39 patients with incomplete cervical spinal cord injury were enrolled and received 4 times of UC-MSC transplantation through the pathways of lumbar puncture. ASIA scores and the Barthel index of activities of daily living (ADL) were used to assess the motion and sensory function, musclar tention, and activities of daily living of spinal cord patients before and half a year after the transplantation. Results The patients had improvement in their motion function, sensory function, musclar tention, and activities of daily living. And the most significant improvement was motor function, the scores changed from 61±22 before operation to 70±18 at 6 month after the transplantation. No obvious adverse reactions occurred, such as surgical site infection, cerebrospinal fluid leakage and central nervous system infection, etc. 15.4% of patients experienced fever in 24 hours after operation, 7.7% of patients experienced low intracranial pressure and 5.1% of patients experienced flank and lower limber pain. Conclusions UC-MSC transplantation significantly improves the sensory function, motion function, function of urination and defecation and perspiration in patients with incomplete cervical spinal cord injury with few adverse reactions.