Tian Chunlei, Wang Xiongwei, Wang Xiaodan, Wang Lei, Wang Xuguang, Wu Shengmei, Wan Zhixian
Institute of Neurology, the First College of Clinical Medical Science, China Three Gorges University, Yichang, China.
Exp Clin Transplant. 2013 Apr;11(2):176-81. doi: 10.6002/ect.2012.0053. Epub 2012 Aug 11.
To explore the clinical therapeutic effects and safety of autologous bone marrow mesenchymal stem cell therapy for traumatic brain injury by lumbar puncture.
A total of 97 patients (24 with persistent vegetative state and 73 with disturbance motor activity) who developed a complex cerebral lesion after traumatic brain injury received autologous bone marrow mesenchymal stem cell therapy voluntarily. The stem cells were isolated from the bone marrow of the patients and transplanted into the subarachnoid space by lumbar puncture.
Fourteen days after cell therapy, no serious complications or adverse events were reported. To a certain extent, 38 of 97 patients (39.2%) improved in the function of brain after transplant (P = .007). Eleven of 24 patients (45.8%) with persistent vegetative state showed posttherapeutic improvements in consciousness (P = .024). Twenty-seven of 73 patients (37.0%) with a motor disorder began to show improvements in motor functions (P = .025). The age of patients and the time elapsed between injury and therapy had effects on the outcomes of the cellular therapy (P < .05). No correlation was found between the number of cell injections and improvements (P > .05).
This study suggests that the bone marrow stem cell therapy is safe and effective on patients with traumatic brain injury complications, such as persistent vegetative state and motor disorder, through lumbar puncture. Young patients improve more easily than older ones. The earlier the cellular therapy begins in the subacute stage of traumatic brain injury, the better the results.
探讨经腰椎穿刺自体骨髓间充质干细胞治疗创伤性脑损伤的临床疗效及安全性。
97例创伤性脑损伤后出现复杂脑损伤的患者(24例持续性植物状态,73例运动活动障碍)自愿接受自体骨髓间充质干细胞治疗。从患者骨髓中分离干细胞,经腰椎穿刺注入蛛网膜下腔。
细胞治疗14天后,未报告严重并发症或不良事件。97例患者中有38例(39.2%)移植后脑功能在一定程度上有所改善(P = 0.007)。24例持续性植物状态患者中有11例(45.8%)治疗后意识有所改善(P = 0.024)。73例运动障碍患者中有27例(37.0%)开始出现运动功能改善(P = 0.025)。患者年龄及受伤至治疗的时间间隔对细胞治疗结果有影响(P < 0.05)。细胞注射次数与改善情况之间未发现相关性(P > 0.05)。
本研究表明,经腰椎穿刺对创伤性脑损伤并发症(如持续性植物状态和运动障碍)患者进行骨髓干细胞治疗是安全有效的。年轻患者比老年患者更容易改善。在创伤性脑损伤亚急性期越早开始细胞治疗,效果越好。