中国组织工程研究与临床康复2011，Vol.15Issue(6)：1065-1069,5.DOI:10.3969/j.issn.1673-8225.2011.06.025
自体骨髓间充质干细胞动脉灌注联合局部注射治疗股骨头坏死
Arterial perfusion combined with regional injection of autologous bone marrow mesenchymal stem cells for femoral head necrosis
史跃 1尹文洲 2陈启忠 3王安明 1刘军权 4刘宏宾 5高从敬1
作者信息
- 1. 解放军第九七医院介入放射科,江苏省徐州市221004
- 2. 徐州市中医院介入放射科,江苏省徐州市221003
- 3. 解放军第九七医院急诊科,江苏省徐州市221004
- 4. 解放军第九七医院实验科,江苏省徐州市221004
- 5. 解放军第九七医院骨科,江苏省徐州市221004
- 折叠
摘要
Abstract
BACKGROUND:Cellular level studies have demonstrated that the proliferative ability of osteoblasts at the proximal end of the femur of patients with femoral head avascular necrosis was decreased, and the number of mesenchymal stem cells (MSCs) was diminished in the femoral head. Therefore, the treatment of femoral head avascular necrosis was done simultaneously when the blood supple was improved. Seed cells with osteogenic ability should be supplemented in the local necrotic region.OBJECTIVE: To observe clinical curative effect of autologous bone marrow MSCs (BMSCs) arterial perfusion in combination with interventional therapy of local puncture injection for treatment of femoral head avascular necrosis.METHODS: In 32 patients with femoral head avascular necrosis in the research group, the catheter was placed on the femoral head to support the artery using seldinger technique via percutaneous-femoral artery puncture . Urokinase 30×104 U and papaverine 30 mg were perfused. 10 mL BMSCs suspension was perfused via the medial femoral circumflex artery. 10 mL BMSCs suspension was infused via multiple points of percutaneous puncture at the necrotic region of the femoral head. The number of BMSCs was 2×107-2 × 108. The 34 patients with femoral head avascular necrosis of the concurrent control group were compared using interventional therapy of artery thrombolysis. The second and third interventional therapy was performed with an interval of 2 and 4 weeks, three times as a course, in both groups.RESULTS AND COMCLUSION: Stenosis, occlusion and revascularization were observed in the femoral head and neck regions of 32 patients of the research group. The vessel dying region of the femoral head was obviously enlarged. Necrotic region was gradually shortened in 29 cases. Following treatment, the improvement degree of range of motion was better in the research group than the control group. The effective rate of pain easement was 93.8％ , and the clinical recovery rate was 84.4％ in the research group, which were greater compared with the control group. Results demonstrated that perfusion of autologous BMSCs in combination with interventional therapy of multiple injection of percutaneous puncture for treatment of femoral head avascular necrosis following artery thrombolysis can elevate curative effect, pain release and improve joint function.关键词
股骨头缺血坏死/骨髓间充质干细胞/动脉灌注/局部穿刺多点注射/数字减影血管造影/介入治疗分类
医药卫生引用本文复制引用
史跃,尹文洲,陈启忠,王安明,刘军权,刘宏宾,高从敬..自体骨髓间充质干细胞动脉灌注联合局部注射治疗股骨头坏死[J].中国组织工程研究与临床康复,2011,15(6):1065-1069,5.
