论文部分内容阅读
背景:细胞移植的安全有效靶点选择,是临床研究的重要方向。对脑内是否存在能发挥重要治疗作用的点或区域,以最大限度对神经网络发挥良性影响进而修复,是研究先行者必须优先考虑的课题之一。目的:通过临床资料分析,证实细胞移植脑内神经网络修复关键点(KPNNR)理论的客观性、真实性和实用性。方法:2003-05/2009-01共有631例各类中枢神经系统疾病患者接受神经网络修复关键点嗅鞘细胞移植,其中609例资料齐全,男392例,女217例;年龄1.2～84(42.87±19.64)岁,病程0.4～35(5.11±5.46)年。疾病分布:肌萎缩侧索硬化432例次、脑性瘫痪110例次、多发性硬化25例次、共济失调12例次、多系统萎缩7例次、遗传性痉挛性截瘫6例次、持续性植物状态6例次、痴呆2例次、脑缺氧后遗症2例次、帕金森叠加综合征2例次、非特异性脑炎后遗症2例次、肾上腺脑白质营养不良1例、核黄疸后遗症1例、皮质基底核变性1例。患者来自75个国家或地区。结果与结论:细胞移植后随访2～8周,平均4周,609例次中526例次神经功能获不同程度改善,近期总改善率为86.37%,其中肌萎缩侧索硬化改善率为87.96%。脑性瘫痪改善率为82.7%,特别是4例伴有癫痫者,术后发作明显减少。共济失调改善率为83.3%。遗传性痉挛性截瘫改善率为83.3%。围手术期出现不良事件共33例次,发生率为5.4%,主要为术后头痛、发热等,多经对症治疗后痊愈。结果提示,大脑内神经网络修复关键点(KPNNR)客观存在,在该点进行嗅鞘细胞移植安全可行,能改善多种中枢神经系统疾病患者的神经功能和(或)延缓病情的进行性恶化。
Background: The choice of safe and effective target of cell transplantation is an important direction of clinical research. It is one of the priorities for research forerunners to explore whether there are points or regions in the brain that can play an important therapeutic role in order to maximize the benign effect on neural networks and then repair them. OBJECTIVE: To confirm the objectivity, authenticity and practicability of KPNNR theory by analyzing clinical data. METHODS: From May 2003 to January 2009, 631 patients with various types of central nervous system diseases underwent neural network repair of the key olfactory ensheathing cell transplantation. Among them, 609 cases were complete with 392 males and 217 females, ranging in age from 1.2 to 84 (42.87) ± 19.64) years old, duration of 0.4 ~ 35 (5.11 ± 5.46) years. Disease distribution: 432 cases of amyotrophic lateral sclerosis, 110 cases of cerebral palsy, 25 cases of multiple sclerosis, ataxia in 12 cases, multiple system atrophy in 7 cases, hereditary spastic paraplegia 6 cases, sustained 6 cases of sexual plant status, 2 cases of dementia, 2 cases of hypoxic sequelae, 2 cases of Parkinson’s syndrome, 2 cases of nonspecific encephalitis sequelae, 1 case of adrenoleukodystrophy, 1 case of nuclear jaundice sequelae 1 Cases, cortical basal degeneration in 1 case. Patients come from 75 countries. RESULTS AND CONCLUSION: After 2 to 8 weeks of follow-up, the mean number of neurological changes in 526 cases improved to some extent in 609 cases. The overall improvement rate was 86.37%. The improvement rate of amyotrophic lateral sclerosis was 87.96% . Cerebral palsy improvement rate was 82.7%, especially in 4 cases with epilepsy, postoperative seizures significantly reduced. Ataxia improvement rate was 83.3%. Hereditary spastic paraplegia improved rate was 83.3%. A total of 33 cases of perioperative adverse events, the incidence was 5.4%, mainly postoperative headache, fever, etc., after more symptomatic treatment recovered. The results suggest that the objective point of KPNNR in the brain exists objectively. Olfactory ensheathing cell transplantation at this site is safe and feasible, which can improve the neurological function and / or delay the progressive deterioration of the disease in patients with a variety of central nervous system diseases.