目的 探究自体脐带血(UCB)输注治疗脑损伤的安全性、可行性以及有效性,为临床上脑损伤患儿的治疗提供一种新的思路和治疗方法,最大限度改善患儿的自理能力。方法 将2018年7月—2020年5月在深圳市儿童医院行自体UCB输注治疗并坚持康复治疗的11例脑损伤患儿作为观察组,功能状态无明显差异的11名脑损伤患儿作为对照组,观察组自UCB输注开始行康复治疗半年,对照组行常规康复治疗半年。两组患儿均在治疗前及治疗半年后对其功能水平进行评估。另外,分析自体UCB治疗组治疗前及治疗后2周神经元烯醇化酶(NSE)及炎症因子的变化。将评估结果及生化指标进行配对样本t检验进行相应分析。结果 治疗后观察组及对照组患儿粗大运动、精细运动及智力粗分均较治疗前有明显改善(P<0.01),治疗后观察组各项得分均明显高于对照组(t=7.214、3.310、3.641,P<0.05或<0.01)。自体UCB治疗组治疗后2周,患儿体内促炎细胞因子(IL-2、IL-6)及NSE有所下降(t=3.304、3.206、3.709,P<0.05),而抗炎细胞因子(IL-4、IL-10)有所升高(t=3.937、4.316,P<0.05),差异均有统计学意义。在治疗期间及远期随访过程未发现明显副作用及并发症。结论 自体UCB输注这一治疗方法安全可行,且结合康复训练可显著改善脑损伤患儿功能水平。
Abstract
Objective To explore the safety, feasibility and effectiveness of autologous umbilical cord blood (UCB) therapy combined with rehabilitation on children with brain injury, in order to provide a new idea and approach for the treatment of children with brain injury in clinic. Methods A total of 11 children with brain injury who underwent autologous UCB infusion treatment and adhered to rehabilitation in Shenzhen Children′s Hospital from July 2018 to May 2020 were selectedinto observation group, and 11 brain injury children with no significant difference in functional status from observation group were selected as control group. The observation group received rehabilitation treatment for half a year since UCB infusion, while the control group only received conventional rehabilitation treatment for half a year. Both groups were evaluated for their functional level before and half a year after treatment. Paired-sample t-test was used to compare the levels of neurone specific enolase (NSE) and inflammatory factors before treatment and 2 weeks after UCB therapy. Results The gross and fine motor skill, rough intelligence scores of the observation and the control group significantly improved after treatment in both observation group and control group. Besides, the above index scores were significantly higher in observation group (t=7.214, 3.310, 3.641, P<0.05). Two weeks after treatment, the pro-inflammatory cytokines(IL-2, IL-6) and NSE levels of the children in observation group were significantly decreased(t=3.304, 3.206, 3.709, P<0.05), while the anti-inflammatory cytokines(IL-4, IL-10) level was significantly increased(t=3.937, 4.316, P<0.05). In addition, no obvious side effects and complications were found during the treatment and long-term follow-up. Conclusion Autologous UCB infusion is a safe and feasible method, and has a significant effect in improving the functional level of children with brain injury when combined with rehabilitation training.
关键词
自体脐带血 /
脑损伤 /
康复治疗 /
疗效
Key words
autologous cord blood /
brain injury /
rehabilitation /
efficacy
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