国际麻醉学与复苏杂志   2013, Issue (11): 8-8
    
我国干细胞治疗神经系统疾病的现状分析
任超, 耿德勤1()
1.徐州医学院附属医院
Analysis of stem cells to treat diseases of the nervous system in China
 全文:
摘要:

目的:探讨干细胞治疗的神经系统疾病病种、年龄分布、干细胞种类、移植途径、治疗效果及随访情况,以数字说明干细胞治疗神经系统疾病到底是希望?还是炒作?以为广大医务工作者提供一些参考,从而推动干细胞在临床应用方面走的更远。方法:应用计算机在万方全文数据库以“干细胞 脑 治疗 临床 患者 title:干细胞 例 keyword:干细胞 脑 abstract:干细胞 脑 治疗 临床”和“干细胞 神经 治疗 临床 患者 title:干细胞 例 keyword:干细胞 神经 abstract:干细胞 神经 治疗 临床”为检索策略,限定文章语言种类为中文,起始时间未做限定,终点时间限定为2012年5月止分别得到文献156篇、234篇,获得文献阅读后进一步剔除,最终得到69篇有价值的文章见参考文献。结果:①2259例患者接受干细胞治疗,疾病种类涉及脊髓病变、脑血管病、运动神经元病、帕金森病等,其中脊髓病变最多(36%);②年龄跨度为0.5-78岁,男女比为1477:782;③所用干细胞种类以自体骨髓间充质干细胞和脐带源最多见;④多以腰穿鞘内注射作为移植途径;⑤治疗效果因观察指标不统一,无法具体计算显效率、好转率等指标,但所有报道均示有一定效果,且不良反应少;⑤随访时间不等,最短1周,最长达37个月,多集中在3个月、6个月。结论:在我国干细胞已被临床上用于治疗多种神经系统疾病,有一定效果,但没有统一的和(或)优先的干细胞移植途径、移植条件及移植时间窗,且研究多为单中心、小样本、非随机的研究,以后需要更多的临床病例和随访资料,最好是采用多中心、随机、双盲、安慰剂平行对照的试验方法去获得最有价值的临床循证依据。

关键词: 干细胞;移植;神经系统疾病
Abstract:

Objective: To study the effect of the treatment of diseases of nervous system with stem cells, involving the types of disease, age range, the types of stem cells, the ways of transplantion and follow-up of cases. While to discus the alternative-treatment with stem cells for diseases of the nervous system is hope or hype? with specific figures. Methods:We searched the related publications from wanfangdata, deadlining 2012-05-31 , with words of “Stem cells , Brain ,Therapy ,Clinical,Patients AND title: stem cell, example AND keyword: stem cell ,brain AND abstract: stem cells ,brain, therapy,clinical,patients” ,while with words of “Stem cells , Nerve ,Therapy ,Clinical,Patients AND title: stem celEl, example AND keyword: stem cell , nerve AND abstract: stem cells , nerve, therapy,clinical,patients”.156 and 234 papers were found relevant respectively,but only 69 of them value.Results:①There were 2259 patients , the types of disease involving Spinal cord lesions, Cerebral vascular disease, Motor neuron disease and Parkinson's disease,e.l;②Ranging in age from 0.5 to 78 years,with male 1477 and female 782;③The majority of the cell types were from bone marrow and umbilical cord sources;④With being lack of uniform standard,it is difficultied to calculate the efficiency and improved rate,e.l,but the treatment was effective in different degrees with few side effects ;⑤The follow-up time is different form 1 week to 37 months. Conclusion: The alternative-treatment with stem cells for diseases of the nervous system has already been in clinical application stage.But these studies were single site, small sample size and non-random.While it is difficultied to establish the uniform standard of the types of stem cells, the ways of transplantion,e.l.Therefore we need more studies which are multicenter, parallel randomized, double-blind and placebo-controlled with more patients and long-term follow-up.

Key words: stem cells; transplantation; diseases of the nervous system