摘要
目的探讨非清髓脐带血干细胞治疗激素抵抗型溃疡性结肠炎临床疗效及内镜变化。方法溃疡性结肠炎患者共11例，均为皮质激素抵抗患者，其中男6例、女5例，年龄18～61岁，病程3～28年。病变在左半结肠4例，全结肠7例；重度10例、中度1例，均为活动期患者。用脐带血干细胞体外分离试剂盒，从60—120ml脐带血中提取CD34＋、CD117＋、CD133＋、C—kit＋、Sca-1＋干细胞，总数〉1．0×10^8个，细胞活力〉96％，用生理盐水10ml制成干细胞悬液，经股动脉插管至肠系膜下动脉，缓慢注入。在使用干细胞治疗前正接受皮质类固醇激素治疗者在开始干细胞治疗后应继续原来的治疗。在取得临床缓解后将激素逐步减量至停用。结果干细胞治疗后12周，总疗效评价：完全缓解7例，有效3例，无效1例。临床症状缓解情况：完全缓解7例，部分缓解3例，无变化1例。肠镜缓解情况：完全缓解6例，部分缓解4例，无变化1例。组织学缓解情况：完全缓解6例，部分缓解4例，无变化1例。大便次数由治疗前每t3平均11．5次降为每日1．6次；血沉由44．5mm／h降为11．5mm／h；C反应蛋白由22．3mg／L降为6．1mg／L；Souahedand疾病活动指数（DAI）由治疗前平均11．1分降为2．32分。10例患者停用皮质激素，1例减量，无一例出现干细胞治疗相关的并发症。随访12个月，复查肠镜，5例完全缓解，3例部分缓解，2例复发。结论非清髓脐带血干细胞治疗激素抵抗型溃疡性结肠炎，近期可使患者临床症状缓解，结肠黏膜愈合，组织学改善，疾病活动指数降低，可停用皮质激素，是安全、有效的治疗。
Objective To study the therapeutic effects of non-myeloablative cord blood stem cell for hormone resistent ulcerative colitis （UC）and endoscopic changes. Methods Eleven UC patients（6 males, 5 females） , aged 18 to 61 years old, and unresponsive to high-dose prednisolone therapy more than 3-28 years, were included. Four cases were left-sided colitis, 7 were pancolitis. Ten were severe cases and 1 was moderate, others were active. Stem cells of CD34~ , CDll7＋ , CD133＋ , C-kit＋ and Sca-1 ＋ were extracted from a total of 60-120 ml cord blood with the isolation kit. The total account was more than 1.0 ~ l0s , and the cell activity was more than 96%. The stems ceils were prepared with normal saline （ 10 ml） to suspen- sion, which was injected into inferior mensenteric artery via femoral catheterization. Those who received pre- treatment corticosteroid resumed their previous therapy . Hormone administration gradually decreased and then ceased at the relief of symptoms. Results After 12 weeks of treatment with stem cell, the total clinical effects were completely remission in 7 cases, improvement in 3 patients, and inefficiency in one case. The clinical symptomatic remissions were complete remission in 7 cases, partial in 3, and inefficiency in 1. The colonoscopic remissions included complete remission in 6 cases, partial in 4, and inefficiency in 1. And the histologic remissions included complete remission in 6 cases, partial in 4, and inefficiency in 1. Bowel movements decreased from 11.5 times to 1.6 per day, erythrocyte sendimentation rate decreased from 44. 5 mm/h to 11.5 mm/h and C reaction protein decreased from 22. 3 mg/L to 6. 1 mg/L. The Sourtherland dis- ease active index （DAI） decreased from 11.1 to 2. 32. Hormone administration ceased in 10 cases and de- creased in 1. There were no complications. The patients were followed up for 12 months, and complete remis- sion in 5 patients, improvement in 3 others and relapse in 2 were observed. Conclusion Non-myeloablative Cord blood stem cell
出处
《中华消化内镜杂志》
北大核心
2010年第8期423-426,共4页
Chinese Journal of Digestive Endoscopy
基金
基金资助：中国博士后科学基金一等资助项目（编号：20070420213）
