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脐带间质干细胞移植显著改善颅脑创伤后遗症患者的神经功能。

Umbilical cord mesenchymal stem cell transplantation significantly improves neurological function in patients with sequelae of traumatic brain injury.

机构信息

Department of Cell Transplantation, General Hospital of Chinese People's Armed Police Forces, Beijing 100039, China.

出版信息

Brain Res. 2013 Sep 26;1532:76-84. doi: 10.1016/j.brainres.2013.08.001. Epub 2013 Aug 11.

Abstract

The aim of this study was to investigate the effects of transplantation with umbilical cord mesenchymal stem cells in patients with sequelae of traumatic brain injury (TBI). The study hypothesis was that umbilical cord mesenchymal stem cell transplantation could safely and effectively improve neurological function in patients with sequelae of traumatic brain injury. Forty patients with sequelae of TBI were randomly assigned to the stem cell treatment group or the control group. The patients in the stem cell treatment group underwent 4 stem cell transplantations via lumbar puncture. All patients of the group were also evaluated using Fugl-Meyer Assessments (FMA) and Functional Independence Measures (FIM) before and at 6 months after the stem cell transplantation. The patients in the control group did not receive any medical treatment (i.e., neither surgery nor medical intervention), and their FMA and FIM scores were determined on the day of the visit to the clinic and at 6 months after that clinical observation. The FMA results demonstrated an improvement in upper extremity motor sub-score, lower extremity motor sub-score, sensation sub-score and balance sub-score in the stem cell transplantation group at 6 months after the transplantation (P<0.05). The FIM results also exhibited significant improvement (P<0.05) in the patient self-care sub-score, sphincter control sub-score, mobility sub-score, locomotion sub-score, communication sub-score and social cognition sub-score. The control group exhibited no improvements after 6 months (P>0.05). All in all, the study results confirmed that the umbilical cord mesenchymal stem cell transplantation improved the neurological function and self-care in patients with TBI sequels. Umbilical cord mesenchymal stem cell transplantation may be a potential treatment for patients with sequelae of TBI. Further research, including a multicenter and large sample size prospective randomized clinical trial, will be required to define definitively the role of umbilical cord mesenchymal stem cell transplantation on sequelae of TBI.

摘要

本研究旨在探讨脐带间充质干细胞移植治疗创伤性脑损伤(TBI)后遗症患者的效果。研究假设脐带间充质干细胞移植可安全、有效地改善 TBI 后遗症患者的神经功能。40 例 TBI 后遗症患者被随机分配到干细胞治疗组或对照组。干细胞治疗组患者通过腰椎穿刺进行 4 次干细胞移植。所有患者在干细胞移植前和移植后 6 个月均采用 Fugl-Meyer 评估(FMA)和功能独立性测量(FIM)进行评估。对照组患者未接受任何治疗(即既未手术也未进行医学干预),仅在就诊当天和就诊后 6 个月记录其 FMA 和 FIM 评分。FMA 结果显示,干细胞移植组患者在移植后 6 个月时上肢运动亚评分、下肢运动亚评分、感觉亚评分和平衡亚评分均有改善(P<0.05)。FIM 结果也显示,患者自理能力亚评分、括约肌控制亚评分、活动能力亚评分、运动能力亚评分、沟通能力亚评分和社会认知亚评分均有显著改善(P<0.05)。对照组患者在 6 个月后无改善(P>0.05)。总之,研究结果证实,脐带间充质干细胞移植可改善 TBI 后遗症患者的神经功能和自理能力。脐带间充质干细胞移植可能是 TBI 后遗症患者的一种潜在治疗方法。需要进一步研究,包括多中心、大样本的前瞻性随机临床试验,以明确脐带间充质干细胞移植在 TBI 后遗症中的作用。

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