摘要
目的：观察中心减压植骨联合骨髓问充质干细胞移植治疗股骨头缺血坏死临床疗效。方法：根据ARCO的骨坏死分期标准，选取I～Ⅱ期病人28例，其中进行中心减压植骨联合干细胞移植的治疗组15例，单纯中心减压植骨的对照组13例。治疗组经过骨髓间充质干细胞采集及分离、中心减压注人造血干细胞以及松质骨植入几步完成，而对照组仅进行中心减压。结果：在术后18个月随访中，治疗组髋关节疼痛指数比对照组明显降低（P〈0．001）；对患侧髋关节行磁共振检查和Harris评分，治疗组评分从55．91±9．70上升为81．98±10．95，而对照组从56．75±7．65上升到67．14±10．95，两组比较治疗效果有统计学差异（P〈O．01）。结论：中心减压植骨联合骨髓间充质干细胞移植治疗早期股骨头缺血坏死安全、有效，但还需要进行大样本及长期随访进一步验证。
Objective： To observe the therapeutic effects of combination of center decompression and implantation of autogenous bone plus mesenchymal stem cells （MSCs） on femoral head osteonecrosis. Methods： 28 patients （32 hips） with stage - I or II osteoneerosis of the femoral head according to the system of the ARCO were enrolled in this trial. 15 patients （bone - marrow graft group） were performed center decompression plus implantation of autologous bone - marrow mononuclear cells and other 13 patients were only performed center decompression （the control group）. In the bone marrow - graft group,, collection of autologous bone marrow, centrifugation of Ficoll density gradient, center decompression and implantation of autogenous bone plus mesenchymal stem cells were implemented one by one. All patients were followed up for 18 months and detected by MRI. Results：Pain index of hip joint at 18 months after operation in bone - marrow graft group demonstrated a significantly greater reduction than that in the control group（P〈0. 001）. The Harris scores increased significantly from 55.91±9. 70 to 81.98±10. 95 in experimental group compared with that of the control group from 56. 75±7. 65 to 67. 14±10. 95 （P〈0.0I）. Conclusion：Implantation of autologous bone - marrow mononuclear cells is a safe and effective treatment for early stages of femoral head osteonecrosis. Long term follow - up and more patients are needed to further confirm the results.
出处
《西南国防医药》
CAS
2008年第6期800-802,共3页
Medical Journal of National Defending Forces in Southwest China
基金
四川省卫生厅科研课题资助项目(060014)
关键词
股骨头坏死
减压植骨
问充质干细胞移植
femoral head osteonecrosis
center decompression
mesenchymal stem cells
transplantation
