自體骨髓間充質(zhì)干細胞治療早期膝骨性關(guān)節(jié)炎的臨床研究
發(fā)布時間：2019-01-26 17:40
【摘要】：目的本研究的目的在于評估早期膝骨性關(guān)節(jié)炎(Osteoarthritis,OA)患者接受關(guān)節(jié)腔內(nèi)注射自體骨髓間充質(zhì)干細胞(Bone Mesenchymal Stem Cells,BMSCs)的臨床療效。分析自體BMSCs對膝骨性關(guān)節(jié)炎的影響,為臨床尋求治療早期膝骨性關(guān)節(jié)炎提供一種新的思路與方法。方法納入對象為河南省人民醫(yī)院自2013年9月至2014年7月間收治的10例早期膝骨性關(guān)節(jié)炎患者,符合中華骨科雜志2007版的骨性關(guān)節(jié)炎診治指南的診斷標(biāo)準(zhǔn),其中男性4例,女性6例,平均年齡48.4歲(從42—57歲),就診前病程3個月—23個月,平均10.6個月,患者膝關(guān)節(jié)有行走或上下樓疼痛、僵硬、摩擦感、下蹲受限等癥狀。入院后常規(guī)檢查,與患者充分溝通,排除有重要臟器嚴重器質(zhì)性病變、血液系統(tǒng)特別是凝血功能異常、精神心理疾病等情況的患者。然后在消毒室中行骨髓穿刺術(shù),經(jīng)患者髂后上棘處穿刺抽取骨髓約100ml,在實驗室中分離出骨髓間充質(zhì)干細胞,并培養(yǎng)擴增至107個水平(從0.92×107個到1.13×107個),后經(jīng)皮注射入患膝關(guān)節(jié)中。治療后分別在1個月、3個月、6個月時予以定期隨訪,隨訪標(biāo)準(zhǔn)參照膝關(guān)節(jié)損傷和骨關(guān)節(jié)炎結(jié)果評分(Knee Injury and Osteoarthritis Outcome Score,KOOS),Lysholm評分,視覺模擬評分法(Visual Analogue Scale,VAS)來評估膝關(guān)節(jié)疼痛,并在末次隨訪中調(diào)查患者滿意度。結(jié)果治療后所納入研究的患者均獲得隨訪,沒有不良事件的發(fā)生。在末次隨訪中,7例患者癥狀顯著減輕,2例好轉(zhuǎn),KOOS平均評分從治療前的61.19分到6個月隨訪時的78.62分。Lysholm評分從治療前的49.64分到6個月隨訪時的86.70分,VAS評分也從治療前的4.5分到研究最終為1.9分。治療前、后KOOS評分、Lysholm評分及VAS評分對比具有統(tǒng)計學(xué)意義(P0.05)。結(jié)論膝關(guān)節(jié)腔內(nèi)注射由自體髂骨獲取的骨髓間充質(zhì)干細胞能減輕早期膝骨性關(guān)節(jié)炎患者疼痛、腫脹、僵硬等癥狀,有助于提高膝關(guān)節(jié)的功能,治療早期膝關(guān)節(jié)OA是有效的。
[Abstract]:Objective to evaluate the clinical efficacy of autologous bone marrow mesenchymal stem cells (Bone Mesenchymal Stem Cells,BMSCs) in patients with early knee osteoarthritis (Osteoarthritis,OA) receiving intraarticular injection of autologous bone marrow mesenchymal stem cells (BMSCs). To analyze the effect of autologous BMSCs on knee osteoarthritis and provide a new method for clinical treatment of early knee osteoarthritis. Methods Ten patients with early knee osteoarthritis treated in Henan Provincial people's Hospital from September 2013 to July 2014 were included. The diagnostic criteria of the guidelines for the diagnosis and treatment of osteoarthritis in the 2007 edition of the Chinese Journal of Orthopaedics, including 4 males, were included. The average age was 48.4 years (from 42 to 57 years). The course of disease was 3 months to 23 months before the visit, with an average of 10.6 months. The knee joints of the patients had walking or floor pain, stiffness, friction, squatting restriction and so on. After admission to the hospital, routine examination, full communication with patients, the exclusion of serious organic diseases of important organs, blood system, especially abnormal blood coagulation, mental and psychological disease patients. Bone marrow mesenchymal stem cells (BMSCs) were extracted from the bone marrow of the patients with posterior superior iliac spine by puncture in the disinfection room. Bone marrow mesenchymal stem cells (BMSCs) were isolated and expanded to 107 levels (from 0.92 脳 107 to 1.13 脳 107). Posterior percutaneous injection into the affected knee joint. They were followed up at 1 month, 3 months and 6 months after treatment respectively. The standard of follow-up was (Knee Injury and Osteoarthritis Outcome Score,KOOS), Lysholm score of knee joint injury and osteoarthritis, (Visual Analogue Scale, of visual analogue score. VAS) was used to assess knee pain and to investigate patient satisfaction at the last follow-up. Results all patients included in the study were followed up and no adverse events occurred. During the last follow-up, the symptoms of 7 patients were significantly alleviated, and 2 patients improved. The average KOOS score ranged from 61.19 before treatment to 78.62 at 6 months follow-up. The Lysholm score ranged from 49.64 before treatment to 86.70 at 6-month follow-up. The VAS score also ranged from 4.5 before treatment to 1.9 in the study. KOOS scores, Lysholm scores and VAS scores were statistically significant before and after treatment (P0.05). Conclusion injection of bone marrow mesenchymal stem cells derived from autogenous iliac bone into the knee joint can relieve pain, swelling and stiffness in patients with early knee osteoarthritis, and can improve the function of knee joint. It is effective in the treatment of early knee joint OA.
【學(xué)位授予單位】：河南中醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R684.3
本文編號：2415734
[Abstract]:Objective to evaluate the clinical efficacy of autologous bone marrow mesenchymal stem cells (Bone Mesenchymal Stem Cells,BMSCs) in patients with early knee osteoarthritis (Osteoarthritis,OA) receiving intraarticular injection of autologous bone marrow mesenchymal stem cells (BMSCs). To analyze the effect of autologous BMSCs on knee osteoarthritis and provide a new method for clinical treatment of early knee osteoarthritis. Methods Ten patients with early knee osteoarthritis treated in Henan Provincial people's Hospital from September 2013 to July 2014 were included. The diagnostic criteria of the guidelines for the diagnosis and treatment of osteoarthritis in the 2007 edition of the Chinese Journal of Orthopaedics, including 4 males, were included. The average age was 48.4 years (from 42 to 57 years). The course of disease was 3 months to 23 months before the visit, with an average of 10.6 months. The knee joints of the patients had walking or floor pain, stiffness, friction, squatting restriction and so on. After admission to the hospital, routine examination, full communication with patients, the exclusion of serious organic diseases of important organs, blood system, especially abnormal blood coagulation, mental and psychological disease patients. Bone marrow mesenchymal stem cells (BMSCs) were extracted from the bone marrow of the patients with posterior superior iliac spine by puncture in the disinfection room. Bone marrow mesenchymal stem cells (BMSCs) were isolated and expanded to 107 levels (from 0.92 脳 107 to 1.13 脳 107). Posterior percutaneous injection into the affected knee joint. They were followed up at 1 month, 3 months and 6 months after treatment respectively. The standard of follow-up was (Knee Injury and Osteoarthritis Outcome Score,KOOS), Lysholm score of knee joint injury and osteoarthritis, (Visual Analogue Scale, of visual analogue score. VAS) was used to assess knee pain and to investigate patient satisfaction at the last follow-up. Results all patients included in the study were followed up and no adverse events occurred. During the last follow-up, the symptoms of 7 patients were significantly alleviated, and 2 patients improved. The average KOOS score ranged from 61.19 before treatment to 78.62 at 6 months follow-up. The Lysholm score ranged from 49.64 before treatment to 86.70 at 6-month follow-up. The VAS score also ranged from 4.5 before treatment to 1.9 in the study. KOOS scores, Lysholm scores and VAS scores were statistically significant before and after treatment (P0.05). Conclusion injection of bone marrow mesenchymal stem cells derived from autogenous iliac bone into the knee joint can relieve pain, swelling and stiffness in patients with early knee osteoarthritis, and can improve the function of knee joint. It is effective in the treatment of early knee joint OA.
【學(xué)位授予單位】：河南中醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R684.3
【參考文獻】
相關(guān)期刊論文 前2條
1 Hyun Joon Paek;Courtney Kim;Stuart K Williams;;Adipose stem cell-based regenerative medicine for reversal of diabetic hyperglycemia[J];World Journal of Diabetes;2014年03期
2 Tsz Kin Ng;Veronica R Fortino;Daniel Pelaez;Herman S Cheung;;WJSC 6~(th) Anniversary Special Issues(2):Mesenchymal stem cells Progress of mesenchymal stem cell therapy for neural and retinal diseases[J];World Journal of Stem Cells;2014年02期
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