CAJ | 학술논문

目的探讨脐带间充质干细胞(umbilical cord mesenchymal stem cells,UMSC)治疗急性百草枯中毒致肺损伤的临床疗效和安全性.方法将2008年12月至2011年12月广州市第12人民医院收治的13例急性百草枯中毒致肺损伤患者分为观察组(5例)及对照组(8例).所有患者均予常规治疗,观察组加用UMSC治疗.应用欧洲重症医学监护医学协会(ESICM)感染相关问题工作组制定的SOFA评分体系,结合我国急性生理学和长期健康评价Ⅱ(acute physiology and chronic health evaluation,APACHEⅡ)对患者进行病情序贯器官衰竭综合评分[SOFA(a)]；同时行肺损伤评分(LIS)评价损伤程度.比较两组患者中毒后第1、3、5、7、14及15天后最大SOFA(a)的差异.结果观察组患者中毒后第15天最大的SOFA(a)评分为(1.80±2.05),明显低于对照组(13.50±7.59),差异有统计学意义(P＜0.05)；观察组治疗后LIS(0.45±0.27)比治疗前(1.15±0.34)明显下降,也明显低于对照组治疗后(2.94±1.20),差异均有统计学意义(P＜0.01).观察组5例患者均存活,复查无诉不适,肝、肾、肺等功能复查正常.肺部CT复查1例患者左下肺后段原病灶部分未完全吸收,其他患者均未见异常.对照组8例患者有1例存活,其余7例均死亡.观察组患者在接受UMSC治疗期间无出现寒战、发热等不良反应.结论 UMSC治疗急性百草枯中毒致肺损伤可能有一定临床应用价值.
목적 탐토제대간충질간세포(umbilical cord mesenchymal stem cells,UMSC)치료급성백초고중독치폐손상적림상료효화안전성.방법 장2008년12월지2011년12월엄주시제12인민의원수치적13례급성백초고중독치폐손상환자분위관찰조(5례)급대조조(8례).소유환자균여상규치료,관찰조가용UMSC치료.응용구주중증의학감호의학협회(ESICM)감염상관문제공작조제정적SOFA평분체계,결합아국급성생이학화장기건강평개Ⅱ(acute physiology and chronic health evaluation,APACHEⅡ)대환자진행병정서관기관쇠갈종합평분[SOFA(a)]；동시행폐손상평분(LIS)평개손상정도.비교량조환자중독후제1、3、5、7、14급15천후최대SOFA(a)적차이.결과 관찰조환자중독후제15천최대적SOFA(a)평분위(1.80±2.05),명현저우대조조(13.50±7.59),차이유통계학의의(P＜0.05)；관찰조치료후LIS(0.45±0.27)비치료전(1.15±0.34)명현하강,야명현저우대조조치료후(2.94±1.20),차이균유통계학의의(P＜0.01).관찰조5례환자균존활,복사무소불괄,간、신、폐등공능복사정상.폐부CT복사1례환자좌하폐후단원병조부분미완전흡수,기타환자균미견이상.대조조8례환자유1례존활,기여7례균사망.관찰조환자재접수UMSC치료기간무출현한전、발열등불량반응.결론 UMSC치료급성백초고중독치폐손상가능유일정림상응용개치.
Objective To evaluate the clinical effect and safety of human umbilical cord mesenchymal stem cells (HUCMSCs) in the treatment of lung injury caused by acute paraquat poisoning.Methods Thirteen patients with lung injury caused by acute paraquat poisoning,who were admitted to Guangzhou No.12 People's Hospital from December 2008 to December 2012,were divided into HUCMSC group (n=5) and control group (n=8).All patients received conventional treatment,while the HUCMSC group was treated with HUCMSCs as an addition.Sequential Organ Failure Assessment (SOFA) system,which was created by the Infection Section of European Society of Intensive Care Medicine,and Acute Physiology and Chronic Health Evaluation Ⅱ were used to acquire the SOFA scores of patients.The lung injury was evaluated with lung injury score (LIS).The two groups were compared with respect to maximum SOFA scores at 1,3,5,7,14,and 15 days after paraquat poisoning.Results The HUCMSC group showed significantly lower maximum SOFA scores than the control group at 15 d after poisoning (1.80±2.05 vs 13.50±7.59,P＜0.05) The LISs of the HUCMSC group after treatment (0.45±0.27) were significantly lower than those of the HUCMSC group before treatment (1.15±0.34)and those of the control group after treatment (2.94±1.20) (P＜0.01).In the HUCMSC group,all patients survived,and they complained no discomfort and showed normal liver,kidney,and lung functions in reexamination; one patient showed incompletely absorbed shadow in the posterior segment of the left lower lobe of the lung during lung CT scan,and no abnormal findings were seen in other patients.In the control group,one patient survived,and others died.No adverse reactions,such as chill and fever,were presented in the HUCMSC group.Conclusion HUCMSCs show promise for clinical application in the treatment of lung injury caused by acute paraquat poisoning.