作者
Yali Wang,Wenxiao Jin,Haiyan Liu,Yuhua Cui,Qingcong Mao,Zhongying Fei,Chunsheng Xiang
摘要
To investigate the safety and efficacy of human umbilical cord mesenchymal stem cells (MSCs) by intra-articular injection for degenerative knee osteoarthritis.Between January 2015 and January 2016, 36 patients with moderate or severe degenerative knee osteoarthritis were randomly devided into 2 groups (n=18). Intra-articular injection of 2.5-3.0 mL human umbilical cord MSCs suspension containing (2-3)×107 cells was performed once a month for 2 times as a course of treatment in the cell treatment group; sodium hyaluronate by intra-articular injection was used once a week for 5 times as a course of treatment in the control group. There was no significant difference in gender, age, body mass index, side, stage of osteoarthritis, course of disease, and preoperative Lysholm score of the knee joint, the Western Ontario and McMaster Universities osteoarthritis index (WOMAC), and SF-36 scale score between 2 groups (P>0.05). The clinical efficacy was evaluated by SF-36 scale score, Lysholm score, and WOMAC score.All patients of 2 groups received a course of treatment. The patients were followed up for 6 months. After injection, the incidences of pain and swelling in the cell treatment group were significantly higher than those in the control group (χ2=16.200, P=0.000; χ2=11.688, P=0.000), but no significant difference was found in the incidence of effusion (χ2=2.118, P=0.146). In the cell treatment group, Lysholm score at 1-6 months after treatment, WOMAC score and SF-36 scale score at 2-6 months after treatment were significantly better when compared with scores before treatment (P<0.05), and no recurrence of knee pain was observed during follow-up. In the control group, there was no significant difference in Lysholm score and SF-36 scale score between pre- and post-treatment (P>0.05); there were significant differences in WOMAC score between pre-treatment and at 1, 2, 3 months after treatment (P<0.05); at 3 months after treatment, 11 patients had joint pain symptoms again. No significant difference was found in the knee joint function score and SF-36 scale score at 1 and 2 months after treatment between 2 groups (P>0.05), but the scores of the cell treatment group were significantly better than those of the control group at 3 and 6 months (P<0.05).It can significantly improve the joint function and quality of life to use intra-articular injection of human umbilical cord MSCs for treating degenerative knee osteoarthritis. It takes effect after 1 month and the treatment effect can be sustained for 6 months.探讨关节腔注射人脐带MSCs治疗退行性膝骨关节炎的安全性及有效性。.2015年1月-2016年1月,将36例符合选择标准的中重度退行性膝骨关节炎患者纳入研究,随机分为两组(n=18)。其中,细胞治疗组关节腔注射人脐带MSCs细胞悬液2.5~3.0 mL,含细胞(2~3)×107个,每月1次,2次为1个疗程。对照组关节腔注射玻璃酸钠,每周1次,5次为1个疗程。两组患者性别、年龄、体质量指数、侧别、病程以及治疗前膝关节Lysholm评分、美国西部Ontario与McMaster大学骨关节炎指数评分(WOMAC)以及SF-36量表评分比较,差异均无统计学意义(P>0.05)。治疗后采用SF-36量表评分、Lysholm评分及WOMAC评分评价临床疗效。.两组患者均完成1个疗程治疗,均随访6个月。注射后细胞治疗组疼痛、肿胀发生率显著高于对照组(χ2=16.200,P=0.000;χ2=11.688,P=0.000),关节腔积液发生率比较差异无统计学意义(χ2=2.118,P=0.146)。细胞治疗组患者治疗后1~6个月Lysholm评分以及2~6个月WOMAC评分、SF-36量表评分均优于治疗前(P<0.05),随访期间患者无膝关节疼痛复发。对照组治疗前后Lysholm评分及SF-36量表评分比较差异均无统计学意义(P>0.05);WOMAC评分治疗后1、2、3个月与治疗前比较差异有统计学意义(P<0.05),治疗后6个月与治疗前比较差异无统计学意义(P>0.05);治疗后3个月11例再次出现关节疼痛症状。两组治疗后1、2个月患者膝关节功能评分及SF-36量表评分比较,差异无统计学意义(P>0.05);但治疗后3、6个月细胞治疗组各项评分均明显优于对照组(P<0.05)。.关节腔注射人脐带MSCs治疗退行性膝骨关节炎可显著改善患者关节功能和生活质量,注射后1个月起效,治疗作用可持续6个月。.