脐带间充质干细胞移植辅助治疗系统性红斑狼疮的疗效观察
Therapeutic Effects of Umbilical Cord Mesenchymal Stem Cells Transplantation on Systemic Lupus Erythematosus
-
摘要: 目的 观察脐带间充质干细胞(UC-MSCs)移植辅助治疗难治性系统性红斑狼疮(SLE)的疗效。方法 37例难治性SLE患者分为对照组(n=20)和治疗组(n=17),均接受糖皮质激素和环磷酰胺(CTX)治疗;治疗组加UC-MSCs移植治疗,每例患者静脉输注移植3×107个UC-MSCs,观察所有患者移植前及移植后2周、1月、2月、3月、6月、9月、12月的临床表现和实验室检查的变化。结果 两组治疗12月后24 h尿蛋白定量、抗核抗体、高敏C反应蛋白、血沉、狼疮活动指数均较治疗前下降(P <0.05),治疗组低于对照组(P<0.05);两组白蛋白(ALB) 、补体(C3、C4)在治疗后高于治疗前,治疗后ALB 、C3治疗组较对照组高(P <0.05);对照组抗双链DNA(Anti-dsDNA)治疗后阳性率〔40%((8/20)〕高于治疗组〔5.88%(1/17)〕(P<0.05);对照组复发率〔50%(10/20)〕高于治疗组〔11.76%(2/17)〕(P <0.05);未发现移植相关并发症。结论 在经典的糖皮质激素加CTX治疗基础上加用UC-MSCs移植治疗难治性SLE,安全有效,复发率低,但样本量小,观察时间短,长期疗效及副作用需进一步研究。Abstract: 【Abstract】 Objective To determine the efficacy of the third generation chemotherapy agents on relapsed post-surgery and advanced pulmonary sarcomatoid carcinoma (PSC). Methods We reviewed the medical records of 32 PSC patients. Their treatment modalities and survival rate, as well as risk factors associated with the survival rate including gender, age, location and size of tumor, relapse, initial diagnosis of stage, pathologic subtypes and smoking history were analysed. Results All of the 32 PSC patients received chemotherapy with gemcitabine combined with cisplatin (GP) or paclitaxel combined with cisplatin (TP). They had a median of 14 months overall survive (OS) and 5 months progress-free survive (PFS). The remission rate was 21.9%. An initial stage Ⅳ diagnosis and a larger than 6 cm tumor in diameter were independent factors associated with poor prognosis. Conclusion The efficacy of TP and GP chemotherapy on patients with relapsed post-surgery and advanced PSC is comparable with that reported by other researchers. An initial stage Ⅳ diagnosis and a larger than 6 cm tumor in diameter are predictors of poor prognosis.