自体骨髓间充质干细胞治疗早期膝骨性关节炎的临床研究
发布时间：2019-01-26 17:40
【摘要】：目的本研究的目的在于评估早期膝骨性关节炎(Osteoarthritis,OA)患者接受关节腔内注射自体骨髓间充质干细胞(Bone Mesenchymal Stem Cells,BMSCs)的临床疗效。分析自体BMSCs对膝骨性关节炎的影响,为临床寻求治疗早期膝骨性关节炎提供一种新的思路与方法。方法纳入对象为河南省人民医院自2013年9月至2014年7月间收治的10例早期膝骨性关节炎患者,符合中华骨科杂志2007版的骨性关节炎诊治指南的诊断标准,其中男性4例,女性6例,平均年龄48.4岁(从42—57岁),就诊前病程3个月—23个月,平均10.6个月,患者膝关节有行走或上下楼疼痛、僵硬、摩擦感、下蹲受限等症状。入院后常规检查,与患者充分沟通,排除有重要脏器严重器质性病变、血液系统特别是凝血功能异常、精神心理疾病等情况的患者。然后在消毒室中行骨髓穿刺术,经患者髂后上棘处穿刺抽取骨髓约100ml,在实验室中分离出骨髓间充质干细胞,并培养扩增至107个水平(从0.92×107个到1.13×107个),后经皮注射入患膝关节中。治疗后分别在1个月、3个月、6个月时予以定期随访,随访标准参照膝关节损伤和骨关节炎结果评分(Knee Injury and Osteoarthritis Outcome Score,KOOS),Lysholm评分,视觉模拟评分法(Visual Analogue Scale,VAS)来评估膝关节疼痛,并在末次随访中调查患者满意度。结果治疗后所纳入研究的患者均获得随访,没有不良事件的发生。在末次随访中,7例患者症状显著减轻,2例好转,KOOS平均评分从治疗前的61.19分到6个月随访时的78.62分。Lysholm评分从治疗前的49.64分到6个月随访时的86.70分,VAS评分也从治疗前的4.5分到研究最终为1.9分。治疗前、后KOOS评分、Lysholm评分及VAS评分对比具有统计学意义(P0.05)。结论膝关节腔内注射由自体髂骨获取的骨髓间充质干细胞能减轻早期膝骨性关节炎患者疼痛、肿胀、僵硬等症状,有助于提高膝关节的功能,治疗早期膝关节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.
【学位授予单位】：河南中医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R684.3
本文编号：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.
【学位授予单位】：河南中医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R684.3
【参考文献】
相关期刊论文 前2条
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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