目的 观察及对比分析自体骨髓间充质干细胞（bone marrow mesenchymal stem cells, BMSCs）和脐血间充质干细胞（umbilical cord blood mesenchymal stem cells, UCBMSCs）移植治疗小儿脑瘫(cerebral palsy, CP)的临床疗效。方法 CP患儿60例，随机分入BMSCs移植组和UCBMSCs移植组，并接受术后6个月的随访，观察对比两组患儿术前与术后高级智能和肢体运动功能的变化。结果 两组高级智能均有改善（包括：智力、语言、性情），高级智能功能改善率差异无统计学意义（7.5% vs 6.7%，P＞0.05）。术后6个月运动功能两组较术前均有改善，BMSCs移植组在竖头（14.3% vs 2.7%）、身体居中性（7.7% vs 2.7%）、翻身（6.7% vs 0）、双上肢抓握等改善率均显著高于UCBMSCs移植组（P＜0.01）。结论 UCBMSCs和BMSCs移植对高级智能功能均有改善；而BMSCs移植对CP患者活动功能改善显著优于UCBMSCs移植。
Abstract
Objective To analyze and compare the clinical effects of bone marrow mesenchymal stem cells (BMSCs) grafting with that of umbilical cord blood mesenchymal stem cells (UCBMSCs) grafting in children with cerebral palsy. Methods Sixty hospitalized patients with cerebral palsy were enrolled from January 1, 2008 to January 1, 2009. They were randomly divided into two groups: UCBMSCs graft group (n=45) and BMSCs graft group (n=15). In all patients recording of the mental and motor representation was performed before grafting, and followed-up in the end of 6 months after grafting. The content of comparison included high-level intelligence and motor function. SPSS16.0 was used for statistical analysis. Results Sixty patients were recruited in the study. Forty-five patients received UCBMSCs grafting, while fifteen patients received BMSCs grafting. The intelligence in the end of 6 months after grafting all have improved, including mentality, language, temperament in the two groups, but there was no significant difference (P>0.05). The motor function including raising head, body at neutral, turning over , grip with hands have improved significantly (P <0.001) in the end of 6 months after grafting. Conclusion The improvement rates of intelligence, language and temperament in UCBMSCs grafting group are not significantly different from those in BMSCs grafting group. However, the improvement of gross motor function in BMSCs grafting group is significantly better than that in UCBMSCs grafting group.
关键词
骨髓间充质干细胞 /
脐血间充质干细胞 /
脑瘫
Key words
bone marrow mesenchymal stem cells /
umbilical cord blood mesenchymal stem cells /
cerebral palsy
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
［1］Netta Harries BPT, Michal Kassirer BPT, Tali Amichal BPT,et al.Changes over years in Gross motor function of 3 -8 year old children with cerebral palsy: using the Gross motor function measure（GMFM-88）［J］.IMAJ 2004,6: 408-412.
［2］吴芳,杨万章,张敏，等.脑瘫患儿应用脐血间质干细胞的临床安全性研究［J］.中西医结合心脑血管病杂志， 2008,6 (12) :1405-1406.
［3］Boyd R, Sakzewski L, Ziviani J,et al.INCITE: A randomised trial comparing constraint induced movement therapy and bimanual training in children with congenital hemiplegia［J］.BMC Neurol， 2010,10:4.
［4］Wang M, Yang Y, Yang D,et al.The immmunomodulatory activity of human umbilical cord blood-derived mesenchymal stem cells in vitro［J］.Immumunology, 2009,126 (2):220-232.
［5］Goldman S A, Schanz S, Windrem M S.Stem cell-based strategies for treating pediatric disorders of myelin［J］.Hum Mol Genet ，2008, 17(R1):R76–83.
［6］Kim S U, Vellis J.Stem Cell-Based Cell Therapy in Neurological Diseases: A Review［J］.J Neurosci Res，2009,87(10):2183–2200.
［7］Lee J S, Hong J M, Moon G J,et al.STARTING collaborators.A long-term follow-up study of intravenous autologous mesenchymal stem cell transplantation in patients with ischemic stroke［J］.Stem Cells ，2010,28(6):1099-1106.
［8］王晓东,杨静,李敏，等.骨髓间充质干细胞移植治疗对小儿脑瘫患者粗大运动功能的影响［J］.中日友好医院学报，2010,24(6):337-342.
［9］赵华,陈允震.自体骨髓基质干细胞移植联合电刺激治疗脊髓损伤的实验研究［J］.中国矫形外科杂志，2010,18（12）:1019-1022.
［10］Harris D T.Cord blood stem cells: a review of potential neurological applications［J］.Stem Cells Rev，2008,4(4):267-274.
［11］Gaspard N, Vanderhaghen P.From stem cells to neural networks: recent advances and perspectives for neurodevelopmental disorders［J］.Dev Med Child Neurol， 2011, 53(1):13-17.
基金
国家教委留学回国人员科研启动基金资助（WZ2011001）
PDF(724 KB)
