摘要
目的探讨脐带间充质干细胞(UCMSC)治疗难治性原发性肾病综合征(PNS)的初步疗效与安全性。方法选取2010年8月至2015年1月难治性PNS患者30例,自愿接受UCMSC治疗,所有患者符合难治性PNS诊断标准,且均经肾活检证实病理类型,免疫抑制治疗未缓解或反复复发。分析UCMSC治疗PNS的疗效、不良反应及复发率情况。采用单因素重复测量方差分析和广义线性混合模型进行统计学分析比较治疗前后差异。结果经统计分析后得出:(1)UCMSC治疗前后24 h尿蛋白定量比较显示:治疗前0周(3.84 g/d)与治疗后4周(2.53 g/d)、8周(1.12 g/d)、16周(0.66 g/d)、24周(0.57 g/d)之间差异均有统计学意义(P均<0.01);血浆白蛋白比较显示:治疗前0周[(24.07±7.30)g/L]与治疗后4周[(29.50±7.92)g/L]、8周[(31.58±7.94)g/L]、16周[(33.43±7.86)g/L]、24周[(35.57±7.68)g/L]之间差异均有统计学意义(P均<0.01);总蛋白比较显示:治疗前0周[(50.03±7.82)g/L]与治疗后4周[(56.83±8.82)g/L]、8周[(58.9±7.94)g/L]、16周[(60.93±8.25)g/L]、24周[(64.6±8.52)g/L]之间差异均有统计学意义(P均<0.01);治疗前后胆固醇的比较显示,UCMSC治疗前0周[(8.62±2.94)mmol/L]与治疗后8周[(8.0±2.91)mmol/L]、16周[(7.31±2.58)mmol/L]、24周[(6.60±2.07)mmol/L]之间差异均有统计学意义(P均<0.01)。(2)完全缓解15例,50﹪;部分缓解6例,20﹪;无效9例,30﹪。(3)在整个UCMSC输注过程及观察过程中并发症轻,对症处理后均痊愈。结论本研究表明UCMSC对改善难治性PNS病情及防止PNS的复发有积极作用,临床缓解率高、起效较快且并发症较少,其远期疗效仍需进一步观察。
Objective To probe into the primary efficacy and safety of umbilical cord mesenchymal stem cell （UCMSC） on the treatment of refractory primary nephrotic syndrome （PNS）. Methods Thirty patients with refractory PNS who voluntarily received the treatment of UCMSC from August 2010 to January 2015 were selected. All patients were in accordance to with the diagnostic criteria of refractory PNS. Their pathological types were confirmed by renal biopsy. No remission was achieved by the immunosuppressive therapy and no repeated recurrence of PNS was found in the patients. The curative effect, adverse reactions and recurrence rate of UCMSC on the treatment of PNS were analyzed. Single factor repeated measure variance analysis and generalized linear mixed model was used to analyze the difference before and after treatment. Results The statistical analysis showed that： （ 1 ） The comparison of 24-hour urinary protein before and after the treatment of UCMSC showed that statistically significant differences were found before treatment （3.84 g/d） and after treatment 4W （2.53 g/d）, 8W （1.12 g/d）, 16W （0.66 g/d）, 24W （0.57 g/d）. The comparison of serum albumin showed that there were statistically significant differences before treatment [（24.07 ± 7.30） g/L] and after treatment 4W [ （29.50±7.92） g/L], 8W [ （31.58 ± 7.94） g/L], 16W[ （33.43 ±7.86） g/L], 24W[ （35.57 ± 7.68） g/L]. The comparison of total protein showed that there were statistically significant differences before treatment [ （50.03 ± 7.82） g/L] and after treatment 4W [ （56.83 ± 8.82） g/L], 8W [ （58.9 ± 7.94） g/L], 16W [ （60.93 ± 8.25 ） g/L], 24W [ （64.6 ± 8.52） g/L] .The comparison of cholesterol before and after treatment showed that there were statistically significant differences before treatment of UCMSC [ （8.62 ± 2.94） mmol/L] and after treatment 8W [ （8.0 ± 2.91 ） mmol/L], 16W[ （7.31 ± 2.58） mmol/L], 24W [ （6.60 ± 2.07） mmol/L]. （2） Complete remission： 15 c
出处
《中华细胞与干细胞杂志（电子版）》
2016年第2期92-96,共5页
Chinese Journal of Cell and Stem Cell（Electronic Edition）
关键词
肾病综合征
脐带
间充质干细胞
治疗结果
Nephrotic syndrome
Umbilical cord
Mesenchymal stem cells,Treatment outcome
