中华风湿病学杂志
中華風濕病學雜誌
중화풍습병학잡지
CHINESE JOURNAL OF RHEUMATOLOGY
2009年
2期
89-92
,共4页
张华勇%冯学兵%马晓蕾%刘布骏%王红%华冰珠%徐婷%赵盛楠%王杰%李建勇%孙凌云
張華勇%馮學兵%馬曉蕾%劉佈駿%王紅%華冰珠%徐婷%趙盛楠%王傑%李建勇%孫凌雲
장화용%풍학병%마효뢰%류포준%왕홍%화빙주%서정%조성남%왕걸%리건용%손릉운
红斑狼疮,系统性%间质干细胞移植
紅斑狼瘡,繫統性%間質榦細胞移植
홍반랑창,계통성%간질간세포이식
Lupus erythematosus,systemic%Mesenchymal stem cell transplantation
目的 探讨异基因骨髓问充质干细胞(MSC)移植治疗难治性系统性红斑狼疮(SLE)的疗效及安全性.方法 血缘相关供者骨髓中分离培养MSC移植治疗11例SLE患者,移植前予环磷酰胺(CTX)0.8～1.8 g,分2～3次静脉输注,输注后隔日予MSC移植,移植细胞数(1×106/kg体质量).评价患者移植前后的临床表现和实验室检查指标的改变.结果 异基因MSC移植后,11例SLE患者随访1～13个月,所有患者均无移植相关并发症.移植后1个月SLE疾病活动评分(SLEDAI)由12±5降低为6±3(11例,P＜0.01).尿蛋白定量(24 h)移植后1个月由(1989±842)mg(518～3690 mg)降低为(1118±700)mg(10例,P＜0.05);移植后2个月[(2478±797)mg vs (924±659)mg,5例,P＜0.05];移植后6个月[(2478±797)mg vs(522±151)mg,5例,P＜0.01].2例肾功能不全患者血肌酐轻度下降.5例低蛋白血症患者移植后1个月血清白蛋白上升[(28±6)g/L vs(32±7)g/L,5例,P＜0.05].移植后1个月血清补体C3升高[(0.50±0.12)g/L vs(0.75±0.10)g/L,9例,P＜0.01],抗核抗体(ANA)滴度降低.结论 异基因MSC移植治疗难治性SLE有效安全.MSC取材方便,扩增迅速,输注安全经济.异基因MSC移植治疗SLE的长期疗效评估需进一步随访观察.
目的 探討異基因骨髓問充質榦細胞(MSC)移植治療難治性繫統性紅斑狼瘡(SLE)的療效及安全性.方法 血緣相關供者骨髓中分離培養MSC移植治療11例SLE患者,移植前予環燐酰胺(CTX)0.8～1.8 g,分2～3次靜脈輸註,輸註後隔日予MSC移植,移植細胞數(1×106/kg體質量).評價患者移植前後的臨床錶現和實驗室檢查指標的改變.結果 異基因MSC移植後,11例SLE患者隨訪1～13箇月,所有患者均無移植相關併髮癥.移植後1箇月SLE疾病活動評分(SLEDAI)由12±5降低為6±3(11例,P＜0.01).尿蛋白定量(24 h)移植後1箇月由(1989±842)mg(518～3690 mg)降低為(1118±700)mg(10例,P＜0.05);移植後2箇月[(2478±797)mg vs (924±659)mg,5例,P＜0.05];移植後6箇月[(2478±797)mg vs(522±151)mg,5例,P＜0.01].2例腎功能不全患者血肌酐輕度下降.5例低蛋白血癥患者移植後1箇月血清白蛋白上升[(28±6)g/L vs(32±7)g/L,5例,P＜0.05].移植後1箇月血清補體C3升高[(0.50±0.12)g/L vs(0.75±0.10)g/L,9例,P＜0.01],抗覈抗體(ANA)滴度降低.結論 異基因MSC移植治療難治性SLE有效安全.MSC取材方便,擴增迅速,輸註安全經濟.異基因MSC移植治療SLE的長期療效評估需進一步隨訪觀察.
목적 탐토이기인골수문충질간세포(MSC)이식치료난치성계통성홍반랑창(SLE)적료효급안전성.방법 혈연상관공자골수중분리배양MSC이식치료11례SLE환자,이식전여배린선알(CTX)0.8～1.8 g,분2～3차정맥수주,수주후격일여MSC이식,이식세포수(1×106/kg체질량).평개환자이식전후적림상표현화실험실검사지표적개변.결과 이기인MSC이식후,11례SLE환자수방1～13개월,소유환자균무이식상관병발증.이식후1개월SLE질병활동평분(SLEDAI)유12±5강저위6±3(11례,P＜0.01).뇨단백정량(24 h)이식후1개월유(1989±842)mg(518～3690 mg)강저위(1118±700)mg(10례,P＜0.05);이식후2개월[(2478±797)mg vs (924±659)mg,5례,P＜0.05];이식후6개월[(2478±797)mg vs(522±151)mg,5례,P＜0.01].2례신공능불전환자혈기항경도하강.5례저단백혈증환자이식후1개월혈청백단백상승[(28±6)g/L vs(32±7)g/L,5례,P＜0.05].이식후1개월혈청보체C3승고[(0.50±0.12)g/L vs(0.75±0.10)g/L,9례,P＜0.01],항핵항체(ANA)적도강저.결론 이기인MSC이식치료난치성SLE유효안전.MSC취재방편,확증신속,수주안전경제.이기인MSC이식치료SLE적장기료효평고수진일보수방관찰.
Objeefive To explore the clinical efficacy and safety of allogenic bone marrow derived mesenchymal stem cells transplantation(MSCT) in patients with refractory systemic lupus erythematosus(SLE).Methods Eleven patients with refractory SLE(nine females and two males aged from 16～41 years(mean 25±8).were entailed in the study.The infcIrmed consents which were approved by the Ethics Committee of the Affiliated Drum Tower Hospital of Naniing University Medical School were obtained from all participants.Bone marrow of healthy donors were obtained and the mesenchymal stem cells(MSC)were expanded in vitro.Each patient was infused MSC 1×106/kg body weight intravenously.Before MSCT.all patients were administrated with cvclophosphamide (CTX)800～1800 mg divided by two to three days.The clinical manifestations and laboratory tests were compared before and after MSCT.Results The eleven patients were followed up for one to thirteen months after MSCT.A11 patients did not develop transplantation related complications.The systemic lupus erythematosus disease activity index (SLEDAI)score decreased from 1 1.7±5.1 to 5.6±3.4 one month after MSCT(n=11,P＜0.01).Ufine protein excretion decreased from(1989+842)mg/24 h to(1118±700)mg/24 h one month after MSCT(n=10,P=0.02).Five patients were followed up for six months and their urine protein excretion decreased significantly [(522±151)mg/24 h vs (2478±797)rag/24 h.n=5.P＜0.01j.The serum albumin level of 5 patients with hypoalbuminemia increased gradually one month after MSCT [(28±6)g/L vs (32±7)g/L,n=5,P＜0.05].Serum complement C3 level increased from(0.50±0.12) g/L to(0.75±0.10)g/L (n=9.P＜0.01) and their anti-nuclear antibody (ANA) titer decreased one month after MSCT.In two patients with chronic renal failure.the serum creatinine decreased gradually.Conclusion Allogenic MSCT is an effective and safe approach for the treatment of refractory SLE.However.extensive follow-up study is needed for long-term benefit evaluation.
