自体骨髓干细胞移植对脑瘫患儿运动功能的影响
发布时间：2019-02-13 10:32
【摘要】：目的 采用GMFM88（Gross Motor Function Measure-88）及FMFM45(Fine MotorFunction Measure-45)量表评价自体骨髓间充质干细胞（Bone MarrowMesenchymal Stem Cells， BM-MSCs）移植对脑瘫（cerebral plasy,CP）患儿运动功能的影响。 方法 收入2010-12/2011-6武警总医院收治的脑性瘫痪患儿20例，每例患儿进行家族史、遗传病、传染病、先天性疾病咨询排查。排除异常后抽取自身骨髓45ml与肝素2ml混匀后立即送无菌细胞室，严格无菌条件下进行自体骨髓间充质干细胞培养。细胞培养完毕后对20例脑性瘫痪患儿进行自体BM-MSCs移植治疗，采用GMFM88及FMFM45项量表对患儿治疗前及治疗后1、3、6个月的粗大及精细运动功能进行评估，采用自身对照的方法研究自体BM-MSCs移植治疗前后患儿运动功能的变化，对移植前、移植后1个月、3个月及6个月内患儿的GMFM及FMFM各功能区分值及原始分、总分进行多因素方差分析，评价BM-MSCs移植对CP患儿运动功能的影响。 结果 17例受试者顺利完成此项研究，3例患儿失访。采用SPSS13.0软件进行统计学分析，结果显示: 1、术后1个月患儿的GMFM88总分及A、B、C功能区得分较移植前显著提高(P＜0.05)；其中A区卧位与翻身功能区,B区坐位功能区,C区爬与跪功能区改善最明显。术后3个月、6个月患儿A、B、C去粗大运动功能评分较移植前仍有提高，D、E区评分也有改善，但并不具有统计学意义。 2、术后FMFM45量表结果显示：术后1个月、3个月及6个月B区上肢关节活动能力、C区抓握能力功能区分值较前提高(P＜0.05)，原始总分及总分均较前显著提高(P＜0.05)；术后1、3、6个月随访过程中未见明显毒副反应及不良事件发生。 结论 BM-MSCs移植治疗小儿脑瘫是安全的，，可有效改善脑瘫患儿的运动功能，疗效以术后1个月提升速度最显著，术后3个月至6个月患儿运动功能仍有进一步提高。
[Abstract]:Objective to evaluate the effect of autologous bone marrow mesenchymal stem cell (Bone MarrowMesenchymal Stem Cells, BM-MSCs) transplantation on motor function in children with cerebral palsy (cerebral plasy,CP) by GMFM88 (Gross Motor Function Measure-88 and FMFM45 (Fine MotorFunction Measure-45. Methods A total of 20 children with cerebral palsy admitted to the General Hospital of Armed Police in 2010-12 / 2011-6 were examined for family history, hereditary diseases, infectious diseases and congenital diseases. After removing the abnormality, the autogenous bone marrow 45ml and heparin 2ml were mixed and sent to the aseptic cell chamber immediately, and autologous bone marrow mesenchymal stem cells were cultured under strict aseptic conditions. After cell culture, 20 children with cerebral palsy were treated with autologous BM-MSCs transplantation. The gross and fine motor function of 20 children with cerebral palsy were evaluated by GMFM88 and FMFM45 scale before treatment and 1, 6 months after treatment. The changes of motor function before and after autologous BM-MSCs transplantation were studied by using self-control method. The scores and original scores of GMFM and FMFM were measured before, 1 month, 3 months and 6 months after transplantation. The effect of BM-MSCs transplantation on motor function of CP children was evaluated by multivariate analysis of variance (ANOVA). Results 17 subjects completed the study successfully and 3 children lost their visits. The results of statistical analysis with SPSS13.0 software showed that: 1, the total score of GMFM88 and the score of the functional area of SPSS13.0 were significantly higher than those before transplantation (P < 0. 05). The most obvious improvement was in area A and the functional area of turning over, the functional area of sitting in area B and the area of climbing and kneeling in area C. After 3 months, 6 months after the operation, the scores of the degenerative motor function of the patients were still improved, and the scores of DU E were improved, but there was no significant difference between the two groups. 2. The results of postoperative FMFM45 scale showed that the ability of upper limb joint movement in area B and the function area of grasping ability in area C were higher than those before operation at 1 month, 3 months and 6 months after operation (P < 0. 05). The original total score and total score were significantly higher than those before (P < 0.05). No side effects and adverse events occurred during the follow-up of 1 and 6 months postoperatively. Conclusion BM-MSCs transplantation is safe in the treatment of children with cerebral palsy and can effectively improve the motor function of children with cerebral palsy.
【学位授予单位】：辽宁医学院
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R742.3
本文编号：2421463
[Abstract]:Objective to evaluate the effect of autologous bone marrow mesenchymal stem cell (Bone MarrowMesenchymal Stem Cells, BM-MSCs) transplantation on motor function in children with cerebral palsy (cerebral plasy,CP) by GMFM88 (Gross Motor Function Measure-88 and FMFM45 (Fine MotorFunction Measure-45. Methods A total of 20 children with cerebral palsy admitted to the General Hospital of Armed Police in 2010-12 / 2011-6 were examined for family history, hereditary diseases, infectious diseases and congenital diseases. After removing the abnormality, the autogenous bone marrow 45ml and heparin 2ml were mixed and sent to the aseptic cell chamber immediately, and autologous bone marrow mesenchymal stem cells were cultured under strict aseptic conditions. After cell culture, 20 children with cerebral palsy were treated with autologous BM-MSCs transplantation. The gross and fine motor function of 20 children with cerebral palsy were evaluated by GMFM88 and FMFM45 scale before treatment and 1, 6 months after treatment. The changes of motor function before and after autologous BM-MSCs transplantation were studied by using self-control method. The scores and original scores of GMFM and FMFM were measured before, 1 month, 3 months and 6 months after transplantation. The effect of BM-MSCs transplantation on motor function of CP children was evaluated by multivariate analysis of variance (ANOVA). Results 17 subjects completed the study successfully and 3 children lost their visits. The results of statistical analysis with SPSS13.0 software showed that: 1, the total score of GMFM88 and the score of the functional area of SPSS13.0 were significantly higher than those before transplantation (P < 0. 05). The most obvious improvement was in area A and the functional area of turning over, the functional area of sitting in area B and the area of climbing and kneeling in area C. After 3 months, 6 months after the operation, the scores of the degenerative motor function of the patients were still improved, and the scores of DU E were improved, but there was no significant difference between the two groups. 2. The results of postoperative FMFM45 scale showed that the ability of upper limb joint movement in area B and the function area of grasping ability in area C were higher than those before operation at 1 month, 3 months and 6 months after operation (P < 0. 05). The original total score and total score were significantly higher than those before (P < 0.05). No side effects and adverse events occurred during the follow-up of 1 and 6 months postoperatively. Conclusion BM-MSCs transplantation is safe in the treatment of children with cerebral palsy and can effectively improve the motor function of children with cerebral palsy.
【学位授予单位】：辽宁医学院
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R742.3
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