摘要
目的观察脐带间充质干细胞(UC-MSCs)移植辅助治疗难治性系统性红斑狼疮(SLE)的疗效。方法37例难治性SLE患者分为对照组(n=20)和治疗组(n=17),均接受糖皮质激素和环磷酰胺(CTX)治疗;治疗组加UC-MSCs移植治疗,每例患者静脉输注移植3×107个UC-MSCs,观察所有患者移植前及移植后2周、1月、2月、3月、6月、9月、12月的临床表现和实验室检查的变化。结果两组治疗12月后24h尿蛋白定量、抗核抗体、高敏C反应蛋白、血沉、狼疮活动指数均较治疗前下降(P<0.05),治疗组低于对照组(P<0.05);两组白蛋白(ALB)、补体(C3、C4)在治疗后高于治疗前,治疗后ALB、C3治疗组较对照组高(P<0.05);对照组抗双链DNA(Anti-dsDNA)治疗后阳性率〔40%((8/20)〕高于治疗组〔5.88%(1/17)〕(P<0.05);对照组复发率〔50%(10/20)〕高于治疗组〔11.76%(2/17)〕(P<0.05);未发现移植相关并发症。结论在经典的糖皮质激素加CTX治疗基础上加用UC-MSCs移植治疗难治性SLE,安全有效,复发率低,但样本量小,观察时间短,长期疗效及副作用需进一步研究。
Objective To observe the efficacy of umbilical cord mesenchymal stem cells （UC-MSCs） transplantation for the patients with refractory systemic lupus erythematosus （SLE）. Methods Thirty seven patients with SIzE were enrolled in this study, and divided into conventional treatment group （control group, n= 20） and UC-MSCS adjuvant treatment group （treatment group, n= 17）. All the patients in both two groups were treated with glucocorticoids and cyclophosphamide （CTX）. In the UC-MSCs group, each patient additionally received the transplantation of 3 × 10^7 UC-MSCs infusion intravenously. The clinical manifestations and laboratory parameters of each patient were observed before the treatments and 2 weeks, 1 month, 2 months, 3 months, 6 months,9 months and 12 months after the treatments. Results All the 37 patients were observed for 12 months. 24 h urinary protein excretion （U-Pro）, anti nuclear antibody （ANA）, erythrocyte sedimentation rate （ESR）, high- sensitivity C-reactive protein （hs-CRP）, systemic lupus erythematosus disease activity index （SLEDAI） of these two groups decreased significantly （P〈0.05）. serum albumin （ALB）, C3, and C4 of two groups were higher after the treatments （P^0.05）. ALB and C3 in treatment group exceeded the control group （P〈0.05）. The positive rates of Anti-dsDNA in control and treatment group were 40% and 10% respectively, while the recurrence rates were 50 % and 20 % respectively, these difference between the two groups were statistically significant （P〈0.05）. There were no transplantation related complications observed. Conclusion UC-MSCs transplantation could be effective and safe for refractory SLE on basis of glucocorticoid and cyclophosphamide therapy.
出处
《四川大学学报（医学版）》
CAS
CSCD
北大核心
2014年第2期338-341,350,共5页
Journal of Sichuan University(Medical Sciences)
基金
云南省科技厅计划项目(2011FB231)资助
关键词
系统性红斑狼疮
脐带间质干细胞
移植
Systemic lupus erythemamosus Umbilical cord-mesenchymal stem cells Tramplantation
