Zhang Che, Huang Li, Gu Jiaowei, Zhou Xihui
Taihe Hospital Affiliated to Hubei Medical College, Shiyan, China.
The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Glob Pediatr Health. 2015 Mar 5;2:2333794X15574091. doi: 10.1177/2333794X15574091. eCollection 2015.
Background. Cerebral palsy (CP) is the most common cause leading to childhood disability. Human umbilical cord blood mesenchymal stem cells (hUCB-MSCs) transplantation is a promising alternative considering the safety and efficacy in current reports. This report represents a case of hUCB-MSCs transplantation combined with basic rehabilitation treatment beginning as early as age 6 months with follow-up as long as 5 years. Methods. A 6-year-old female patient was diagnosed with CP at age 6 months. The patient accepted 4 infusions of intravenous hUCB-MSCs in each course and received 4 courses of transplantation totally. A series of assessments were performed before the first transplantation, including laboratory tests, CDCC Infant Mental Development Scale, and Gross Motor Function Measure-88 (GMFM-88). Then annual assessments using the GMFM-88, Ashworth spasm assessment, and comprehensive function assessment scale were made in addition to the annual laboratory tests. In addition, electroencephalography and brain magnetic resonance imaging were conducted before transplantation and in the follow-up phase. Rehabilitation and safety follow-up have been ongoing for 5 years up to date. Results. There was no complaint about adverse effects during hospitalization or postoperative follow-up. Motor function recovered to normal level according to the evaluation of scales. Language function improved significantly. Linguistic rehabilitation therapy was enhanced for further improvement. Conclusions. The clinical application of hUC-MSCs combined with basic rehabilitation treatment was effective and safe for improving motor and comprehensive function in a patient with CP.
背景。脑性瘫痪(CP)是导致儿童残疾的最常见原因。考虑到目前报告中的安全性和有效性,人脐带血间充质干细胞(hUCB-MSCs)移植是一种有前景的替代方法。本报告介绍了一例hUCB-MSCs移植联合基础康复治疗的病例,该治疗最早从6个月大开始,随访长达5年。方法。一名6岁女性患者在6个月大时被诊断为CP。患者在每个疗程接受4次静脉输注hUCB-MSCs,共接受4个疗程的移植。在首次移植前进行了一系列评估,包括实验室检查、CDCC婴儿智力发育量表和粗大运动功能测量-88(GMFM-88)。然后除了每年的实验室检查外,每年还使用GMFM-88、Ashworth痉挛评估和综合功能评估量表进行评估。此外,在移植前和随访阶段进行了脑电图和脑磁共振成像检查。截至目前,康复和安全性随访已持续5年。结果。住院期间或术后随访均无不良反应主诉。根据量表评估,运动功能恢复到正常水平。语言功能显著改善。加强了语言康复治疗以进一步改善。结论。hUC-MSCs联合基础康复治疗在改善CP患者的运动和综合功能方面临床应用有效且安全。