摘要
目的探讨显微外科手术联合自体骨髓干细胞动员及辛伐他汀治疗动脉瘤性蛛网膜下腔出血的临床疗效及安全性。方法选取术前Hunt-Hess分级Ⅱ-Ⅳ级动脉瘤性蛛网膜下腔出血患者69例,经显微外科动脉瘤夹闭术后随机分为2组:对照组34例,显微外科手术后常规治疗;联合治疗组35例,显微外科手术后常规治疗联合自体骨髓干细胞动员及辛伐他汀治疗。按美国国立卫生研究院制定的卒中量表(NIHSS)和巴塞尔(Bar-thel)指数评分,测定2组外周血CDl33+CD34+细胞数。结果 69例动脉瘤性蛛网膜下腔出血患者均完全夹闭动脉瘤,术后3天对照组与联合治疗组患者NIHSS评分及Barthel指数比较无显著性差异(P>0.05),术后1,3,6个月对照组与联合治疗组患者NIHSS评分及Barthel指数比较有显著性差异(P<0.05),且2组患者NIHSS评分均依次降低,Barthel指数均依次升高;术后3周对照组与联合治疗组患者外周血CDl33+CD34+细胞数均高于治疗前,且联合治疗组外周血CDl33+CD34+细胞数显著高于对照组(P<0.05)。全过程所有患者均未出现明显不良反应。结论显微外科手术联合自体骨髓干细胞动员及辛伐他汀治疗动脉瘤性蛛网膜下腔出血不仅夹闭动脉瘤祛除蛛网膜下腔出血的病因,而且通过动员自体干细胞参与受损脑组织的功能修复,是治疗动脉瘤性蛛网膜下腔出血的安全有效方法,值得临床推广。
Objective To observe the effect and safety of microsurgery combined with autologous bone marrow stem cells（BMSCs） mobilization and simvastatin on aneurismal subarachnoid hemorrhage.Methods Totally 69 cases of aneurismal subarachnoid hemorrhage（Hunt-Hess Ⅱ-Ⅳ）were randomly divided into 2 groups after microsurgery.Control group（n=34） received microsurgery,and the unite treatment group（n=35） received the additional autologous BMSCs mobilization and simvastatin in addition to the therapy in control group.The patients underwent and follow-up neurological assessment using the Barthel Index and neurological impairment（NIHSS score）.Peripheral blood CDl33＋CD34＋cell were analyzed with flow cytometer.Results All of 69 patients were completely clipping aneurysm.The NIHSS score and Barthel index were not significantly different in 2 groups 3 days after microsurgery（P〉0.05）.In 1,3 and 6 months after microsurgery,compared control group with unite treatment group,there were significantly differences（P〈0.05）,While the NIHSS scores of 2 groups stepped down,and the Barthel index stepped up in turn.The CDl33＋CD34＋ cells in unite treatment group were significantly higher compared with unite treatment group（P〈0.05）.No patients experienced serious adverse reaction during the treatment.Conclusions Microsurgery combined with therapy of autologous bone marrow stem cells mobilization and simvastatin for aneurismal subarachnoid hemorrhage not only clipping aneurysm dispel the etiology of subarachnoid hemorrhage and through the mobilization autologous stem cell mobilization in the function of repairing the damaged brain tissue,which is effective and safe for aneurismal subarachnoid hemorrhage and worthy to apply in clinic.
出处
《医药论坛杂志》
2011年第21期35-38,共4页
Journal of Medical Forum
基金
河南省杰出人才计划项目(084200410011)
关键词
显微外科
动脉瘤
蛛网膜下腔出血
骨髓干细胞
动员
Microsurgery
Aneurisma
Subarachnoid Hemorrhage
Bone marrow stem cells
Mobilization
