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人脐带血单个核细胞静脉移植治疗轻中度阿尔茨海默病的临床研究OACSTPCD

A clinical study on intravenous transplantation of human umbilical cord blood mononuclear cells for treating mild-to-moderate Alzheimer disease

中文摘要英文摘要

目的 观察人脐带血单个核细胞(hUCB-MNC)静脉移植治疗轻中度阿尔茨海默病(AD)患者的临床疗效.方法 选取轻中度AD患者50例,随机分为治疗组和对照组,每组25例.治疗组给予hUCB-MNC静脉输注,对照组给予盐酸多奈哌齐口服,两组疗程均为12周.评价两组治疗前后磁共振质子波谱技术(1H-MRS)中N-乙酰天冬氨酸/肌酸(NAA/Cr)、胆碱/肌酸(Cho/Cr)、肌醇/肌酸(mI/Cr)、N-乙酰天冬氨酸/肌醇(NAA/mI)比值、尿AD7c-NTP水平、蒙特利尔认知评估量表(MoCA)得分.结果 治疗组治疗后较治疗前MoCA总分及各认知域评分提高,尤其在记忆力、视空间与执行力、注意力、定向力领域的提高优于对照组(P<0.05).治疗组治疗后较治疗前NAA/Cr、Cho/Cr、NAA/mI升高,mI/Cr降低(P<0.05),且治疗组NAA/Cr、Cho/Cr、NAA/mI、mI/Cr改善程度优于对照组(P<0.05).治疗组治疗后较治疗前尿AD7c-NTP水平降低,且治疗组尿AD7c-NTP改善程度优于对照组(P<0.05).结论 hUCB-MNC可明显改善轻中度AD患者的记忆力、视空间与执行力等认知域,并且能改善轻中度AD患者的脑代谢水平及减轻神经元损伤程度,1H-MRS结合尿AD7c-NTP的评估模式可为临床治疗AD提供新的思路和方法.

Objective To observe the clinical efficacy of intravenous transplantation of human umbilical cord blood mononuclear cells(hUCB-MNC)in the treatment of patients with mild-to-moderate Alzheimer disease(AD).Methods Fifty patients with mild-to-moderate AD were randomly divided into treatment group and control group,with 25 cases in each group.The treatment group received intravenous infusion of hUCB-MNC,while the control group was given donepezil hydrochloride by oral administration.The course of treatment was 12 weeks in both groups.We evaluated 1H-proton magnetic resonance spectroscopy(1H-MRS)parameters[N-acetylaspartate/creatinine(NAA/Cr),choline/cre-atinine(Cho/Cr),inositol/creatinine(mI/Cr),and N-acetylaspartate/inositol(NAA/mI)ratios],urinary AD7c-NTP level,and Montreal Cognitive Assessment(MoCA)score in both groups before and after treatment.Results After treat-ment,the treatment group showed significant increases in the total MoCA score and the score of each cognitive domain;and the treatment group had significant greater improvements in memory,visuospatial and executive function,attention,and orientation than the control group(all P<0.05).After treatment,the treatment group showed significantly increased NAA/Cr,Cho/Cr,and NAA/mI ratios and a significantly decreased mI/Cr ratio;and the improvements in NAA/Cr,Cho/Cr,NAA/mI,and mI/Cr were significantly greater in the treatment group than in the control group(all P<0.05).The uri-nary AD7c-NTP level in the treatment group was significantly reduced after treatment,and the improvement was signifi-cantly better compared with the control group(both P<0.05).Conclusion Intravenous transplantation of hUCB-MNC can significantly improve memory,visuospatial and executive function,and other cognitive domains as well as brain me-tabolism and neuronal damage in patients with mild-to-moderate AD.1H-MRS and urinary AD7c-NTP evaluations can pro-vide new ideas for the clinical treatment of AD.

孙旭;李成君;衣红杰;宋吉美;王蕾

青岛市西海岸新区中医医院,山东 青岛 266000山东中医药大学第二附属医院,山东 济南 250001广州中医药大学,广东 广州 510000

临床医学

脐带血单个核细胞阿尔茨海默病静脉移植

Umbilical cord blood mononuclear cellAlzheimer diseaseIntravenous transplantation

《中风与神经疾病杂志》 2024 (008)

718-722 / 5

山东省医学会脐带血临床专项(YXH2021ZX061)

10.19845/j.cnki.zfysjjbzz.2024.0138

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