脐带间充质干细胞治疗难治性系统性红斑狼疮临床分析

摘要

Objective To study the effects and security of umbilical cord mesenchymal stem cells transPlantation (UC-MSCs) for Patients with refractory systemic luPus erythematosus(SLE). Methods Forty Patients with refractory SLE were divided into two grouPs at random.All of Patients were treated for glucocorticoid and CTX, then Patients of the 2 grouP were transPlanted for UC-MSCs.All of Patients were observed before and 2 weeks after treatment,1 month,2 months,3 months,6 months,9 months and 12 months of clinical manifestations and laboratory Parameters . Results 2 weeks after treatment, 60%of the 1 grouP were SLEDAI<10 scores, and the 2 grouPs were 90%. There was statistically significant difference between the two grouPs (χ2=7.619, P=0.006). 1 year after treatment, PLT,ALB and C3 of the 2 grouPs were more than the 1 grouPs(P<0.05). SLEDAI,U-Pro,ESR and Hs-CRP of the 1 grouPs were more than the 2 grouPs(P<0.05). WBC,Cr and C4 of the two grouPs had not statistically significant difference(P﹥0.05). The recurrence rate of the 1 grouPs was 45%. Of the 2 grouPs was 15%.There was statistically significant difference between the two grouPs (χ2=4.286, P=0.038). Conclusion It is effective and safe for refractory SLE to transPlant UC-MSCs after using glucocorticoid and CTX. Further observation is required to evaluate long term efficacy and adverse reaction of UC-MSCs.%目的：探讨脐带间充质干细胞（umbilical cord mesenchymal stem cells， UC-MSCs）移植治疗难治性系统性红斑狼疮（systemic lupus erythe matosus， SLE）的疗效和安全性。方法：40例难治性SLE随机分成两组，1组糖皮质激素加CTX治疗，2组在此基础上移植UC-MSCs，观察两组病例治疗前和治疗后2周、1个月、2个月、3个月、6个月、9个月、12个月的临床表现和实验室检查的变化。结果：治疗后2周患者SLEDAI评分降至＜10分者1组12例（60％），2组18例（90％），两组比较差异有统计学意义（字2＝7．619，P＝0．006）；治疗1年后观察结果显示：PLT、ALB、C3均数2组较1组高（P＜0．05），SLEDAI、U-Pro、ESR、hs-CRP 1组较2组高（P＜0．05），WBC、Cr、C4两组差异无统计学意义（P＞0．05）；1组复发率为45％，2组15％，两组差异有统计学意义（χ2＝4．286，P＝0．038）。结论：难治性SLE在使用糖皮质激素加CTX治疗的基础上移植UC-MSCs安全、有效，但其远期疗效及不良反应有待进一步观察。