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静脉输注粒细胞集落刺激因子动员的外周血单个核细胞对脑瘫患儿上肢功能的影响

Effect of Intravenous Infusion of G-CSF-Mobilized Peripheral Blood Mononuclear Cells on Upper Extremity Function in Cerebral Palsy Children.

作者信息

Park Kyeong Il, Lee Young-Ho, Rah Wee-Jin, Jo Seung Hwi, Park Si-Bog, Han Seung Hoon, Koh Hani, Suh Jin Young, Um Jang Soo, Choi Eun Hye, Park Un Jin, Kim Mi Jung

机构信息

Department of Rehabilitation Medicine, Hanyang University College of Medicine, Seoul, Korea.

Department of Pediatrics, Hanyang University Medical Center, Seoul, Korea.

出版信息

Ann Rehabil Med. 2017 Feb;41(1):113-120. doi: 10.5535/arm.2017.41.1.113. Epub 2017 Feb 28.

Abstract

OBJECTIVE

To investigate the effect of intravenous infusion of peripheral blood mononuclear cells (mPBMC) mobilized by granulocyte-colony stimulating factor (G-CSF) on upper extremity function in children with cerebral palsy (CP).

METHODS

Fifty-seven children with CP were enrolled. Ten patients were excluded due to follow-up loss. In total, 47 patients (30 males and 17 females) were analyzed. All patients' parents provided signed consent before the start of the study. After administration of G-CSF for 5 days, mPBMC was collected and cryopreserved. Patients were randomized into two groups 1 month later. Twenty-two patients were administered mPBMC and 25 patients received normal saline as placebo. Six months later, the two groups were switched, and administered mPBMC and placebo, respectively. Quality of Upper Extremity Skills Test (QUEST) and the Manual Ability Classification System (MACS) were used to evaluate upper motor function.

RESULTS

All subdomain and total scores of QUEST were significantly improved after mPBMC and placebo infusion, without significant differences between mPBMC and placebo groups. A month after G-CSF, all subdomain and total scores of QUEST were improved. The level of MACS remained unchanged in both mPBMC and placebo groups.

CONCLUSION

In this study, intravenously infused mPBMC showed no significant effect on upper extremity function in children with CP, as compared to placebo. The effect of mPBMC was likely masked by the effect of G-CSF, which was used in both groups and/or G-CSF itself might have other neurotrophic potentials in children with CP.

摘要

目的

探讨粒细胞集落刺激因子(G-CSF)动员的外周血单个核细胞(mPBMC)静脉输注对脑瘫(CP)患儿上肢功能的影响。

方法

纳入57例CP患儿。10例因失访被排除。共分析47例患者(30例男性和17例女性)。所有患者的父母在研究开始前均签署了知情同意书。给予G-CSF 5天后,采集mPBMC并冻存。1个月后将患者随机分为两组。22例患者接受mPBMC输注,25例患者接受生理盐水作为安慰剂。6个月后,两组进行交叉,分别给予mPBMC和安慰剂。采用上肢技能测试质量(QUEST)和手动能力分类系统(MACS)评估上肢运动功能。

结果

mPBMC和安慰剂输注后,QUEST的所有子域得分和总分均显著改善,mPBMC组与安慰剂组之间无显著差异。给予G-CSF 1个月后,QUEST的所有子域得分和总分均有所改善。mPBMC组和安慰剂组的MACS水平均保持不变。

结论

在本研究中,与安慰剂相比,静脉输注mPBMC对CP患儿的上肢功能无显著影响。mPBMC的作用可能被两组均使用的G-CSF的作用所掩盖,和/或G-CSF本身可能对CP患儿具有其他神经营养潜能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/35d0/5344812/b0ab2e379a8e/arm-41-113-g001.jpg

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