中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (27): 5097-5102.doi: 10.3969/j.issn.2095-4344.2012.27.030

• 干细胞移植 stem cell transplantation • 上一篇    下一篇

单侧、双侧髂骨取血及取血量与骨髓单个核细胞浓度与早期股骨头坏死 治疗效果的关系

石少辉1，李子荣2，孙 伟2，王佰亮2，许树清3，王冉东1   

  1. 1 航空总医院关节创伤外科，北京市 100012；中日友好医院，
    2骨坏死与关节保留重建中心，3临床研究所，北京市 100029
  • 收稿日期:2011-11-23 修回日期:2011-12-04 出版日期:2012-07-01 发布日期:2013-11-01
  • 作者简介:石少辉☆，男，1977年生，山东省日照市人，汉族，2009年北京协和医学院毕业，博士，主治医师，主要从事骨坏死、关节创伤、组织工程方面的研究。

Effect of quality and quantity of blood taken from unilateral and bilateral iliac on the concentration of bone marrow mononuclear cells and the efficacy of bone marrow mononuclear cells transplantation for the treatment of early femoral head necrosis

Shi Shao-hui1, Li Zi-rong2, Sun Wei2, Wang Bai-liang2, Xu Shu-qing3, Wang Ran-dong1   

  1. 1Department of Joint Trauma Surgery, Aviation General Hospital, Beijing 100029, China;
    2Center for Osteonecrosis & Joint-preserving Reconstruction, Beijing 100029, China;
    3Clinical Research Institute of China-Japan Relationship Hospital, Beijing 100029, China
  • Received:2011-11-23 Revised:2011-12-04 Online:2012-07-01 Published:2013-11-01
  • About author:Shi Shao-hui☆, M.D., Attending physician, Department of Joint Trauma Surgery, Aviation General Hospital, Beijing 100029, China ssh_snake@yahoo.com.cn

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257

被引次数

2

摘要：

背景：以单侧、双侧髂骨取血及取血量是否会影响骨髓单个核核细胞的浓度呢？
目的：观察自体骨髓单个核细胞浓度差异对移植治疗早期股骨头坏死的疗效影响。
方法：回顾性分析髓心减压加自体单个核细胞移植股骨头坏死患者120例/168髋临床资料，其中单侧髂骨取血200 mL，27例/39髋，单侧髂骨取血300 mL，29例/40髋；双侧髂骨取血200 mL，30例/42髋，双侧髂骨取血300 mL，34例/47髋。髂骨取血后在细胞分离机将骨髓血梯度离心，细胞分离前后行单个核细胞计数，髓芯减压后移植注入骨坏死区。随访12~36个月，观察治疗前后患者CT影像学及髋关节Harris评分改变。
结果与结论：单侧及双侧髂骨取血 200 mL分离后所得单个核细胞计数与取血300 mL比较，差异均无显著性意义(P > 0.05)，但双侧明显高于单侧(P < 0.01)。各组髋关节功能Harris评分，移植前比较差异无显著性意义(P > 0.05)，移植后Harris评分及优良率显著提高(P < 0.05， P < 0.01)。与单侧髂骨取血组比较，双侧髂骨取血移植后髋关节功能Harris评分提高，差异有显著性意义(P < 0.01)。说明髓芯减压加自体骨髓单个核细胞移植是治疗早期股骨头缺血性坏死安全有效的方法之一；双侧髂骨取血所分离单个核细胞浓度明显侧高于单侧，且短期随访临床疗效较好。

关键词: 股骨头坏死, 单个核细胞, 髓芯减, 细胞移植, 自体骨髓

Abstract:

BACKGROUND: Whether the quality and quantity of blood taken from unilateral and bilateral iliac would affect the concentration of bone marrow mononuclear cells?
OBJECTIVE: To observe the efficacy of mononuclear cells concentration on early femoral head necrosis treated by autologous bone marrow mononuclear cells transplantation.
METHODS: The clinical data of 120 patients of 168 hips with femoral head necrosis were retrospectively analyzed, and all the patients were processed with core decompression plus autologous mononuclear cells transplantation. This study included 27 cases (39 hips), who were taken blood about 200 mL from the unilateral iliac, 29 cases (40 hips), who were taken blood about 300 mL from the unilateral iliac, 30 cases (42 hips), who were taken blood about 200 mL from the bilateral iliac, 34 cases (47 hips), who were taken blood about 300 mL from the bilateral iliac. After the blood was taken from lilac, the bone marrow blood gradient centrifugation was performed by cell segregating, and the mononuclear cells count was observed before and after separation; the mononuclear cells were injected into the bone necrosis area after core decompression. All the patients were followed-up for 12-36 months, and the CT imaging and the Harris score of the hips in the patients before and after treatment were observed.
RESULTS AND CONCLUSION: There was no significant difference of the mononuclear cells count between subgroup of 200 mL and 300 mL taken from unilateral and bilateral iliac (P > 0.05), but the mononuclear cells count taken from the bilateral iliac was significantly higher than that taken from the unilateral iliac (P < 0.01). There was no significant difference of the Harris score between groups before transplantation (P > 0.05), and compared with before transplantation, the Harris score and the hip fineness rate was significantly increased after transplantation (P < 0.05, P < 0.01). In short, core decompression plus autologous bone marrow mononuclear cell transplantation is an easy and safe method for the treatment of early femoral head necrosis. The concentration of mononuclear cells after centrifugation when taken from bilateral iliac is significantly higher than that taken from unilateral iliac, and the better follow-up the higher concentration.

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