脐带间充质干细胞与脂肪源性血管基质组分治疗膝骨关节炎

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摘要目的〓评估人同种异体脐带间充质干细胞(umbilical cord mesenchymal stem cells，UC-MSCs)与自体脂肪来源血管基质组分(stromal vascular fraction，SVF)在膝关节骨关节炎治疗中的临床应用疗效。方法〓选取自2020年1月至2021年6月经中国人民解放军北部战区总医院诊治的骨关节炎患者44例，随机分组为UC-MSCs组(关节腔注射UC-MSCs)和SVF组(关节腔注射SVF)。UC-MSCs组22例，男8例，女14例；年龄46～63岁，平均(55.6±5.8)岁；左膝13例，右膝9例。SVF组22例，男10例，女12例；年龄48～65岁，平均(55.2±7.3)岁；左膝14例，右膝8例。记录注射前及注射后6、12个月西安大略和麦克马斯特大学(the Western Ontario and McMaster Universities，WOMAC)骨关节炎评分、Lysholm膝关节功能评分、疼痛视觉模拟评分(visual analogue scale，VAS)及末次随访患肢膝关节影像学表现，综合评估两种方法治疗膝关节骨关节炎的疗效。结果〓40例患者获得随访，随访时间12～21个月，平均(14.9±5.2)个月。4例失访，UC-MSCs组1例，SVF组3例。两组病例术前一般资料相比差异无统计学意义(P＞0.05)；UC-MSCs组患者注射后WOMAC评分、Lysholm评分及VAS评分均优于SVF组(P＜0.05)。两组随访期间均未见严重不良反应，但UC-MSCs组不良反应发生率高于SVF组(P＜0.05)。结论〓两种制剂用于治疗膝关节骨关节炎均有效。UC-MSCs的疗效优于自体脂肪来源SVF，但注射后不良反应(发热、肿胀)发生率较自体脂肪来源SVF高。

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	李宝
	崔向红
	李涵
	刘铭
	李灏坤
	刘欣伟
	李思桐

关键词 ：间充质干细胞, 血管基质组分, 膝关节, 骨关节炎, 软骨再生

Abstract：Objective〓To evaluate the clinical efficacy of human allogenic umbilical cord mesenchymal stem cells(UC-MSCs) and autologous fat-derived stromal vascular fraction(SVF) in the treatment of knee osteoarthritis.Methods〓Between January 2020 and June 2021，44 patients with osteoarthritis treated at the General Hospital of Northern Theater Command were randomly assigned to two groups：The UC-MSCs group (where UC-MSCs were injected into the articular cavity) and the SVF group (where SVF was injected into the joint cavity).The UC-MSCs group comprised 22 patients，including 8 males and 14 females，with an age range from 46 to 63 years and an average age of (55.6±5.8) years.Of these，13 cases involved the left knee and 9 cases the right knee.The SVF group also had 22 patients，including 10 males and 12 females，with an age range from 48 to 65 years and an average age of (55.2±7.3) years.Within this group，14 cases involved the left knee and 8 cases the right knee.Before injection and at 6 and 12 months post-injection，the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)，Lysholm score，visual analogue scale (VAS)，and imaging findings of the affected knee joint were used to comprehensively evaluate the efficacy of both treatment methods in managing knee osteoarthritis.Results〓 A total of 40 patients were followed up for a duration ranging from 12 to 21 months，averaging (14.9±5.2) months.However，four cases were lost to follow-up，with one from the UC-MSCs group and three from the SVF group.Preoperatively，there was no statistically significant difference in general information between the two groups (P＞0.05).Post-injection，the WOMAC score，Lysholm score，and VAS of patients in the UC-MSCs group were all superior to those in the SVF group (P＜0.05).During the follow-up period，no serious adverse reactions were observed in either group，but the incidence of adverse reactions in the UC-MSCs group was higher than that in the SVF group (P＜0.05).Conclusion〓Both formulations are effective in treating knee osteoarthritis.The efficacy of UC-MSCs is superior to SVF，but the incidence of adverse reactions (fever，swelling) after injection is higher than that of SVF.

Key words： mesenchymal stem cells stromal vascular fraction knee joint osteoarthritis cartilage regeneration

基金资助:沈阳中心自选科研项目(2020-484)

通讯作者: 李思桐

作者简介: 李宝(1997－ )，男，医师，中国人民解放军北部战区总医院骨科，728977291@qq.com

引用本文:

李宝，崔向红，李涵，刘铭，李灏坤，刘欣伟，李思桐. 脐带间充质干细胞与脂肪源性血管基质组分治疗膝骨关节炎[J]. 实用骨科杂志, 2024, 30(6): 508-.
Li Bao，Cui Xianghong，Li Han，Liu Ming，Li Haokun，Liu Xinwei，Li Sitong. Efficacy of Umbilical Cord Mesenchymal Stem Cells and Stromal Vascular Fraction in Treatment of Knee Osteoarthritis. sygkzz, 2024, 30(6): 508-.

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http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2024/V30/I6/508

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