《中国康复理论与实践》

《中国康复理论与实践》 ›› 2010, Vol. 16 ›› Issue (2): 146-148.

• 论文 • 上一篇    下一篇

嗅鞘细胞移植治疗脊髓损伤后顽固性神经性疼痛17例报道

陈琳1,2，江昭1，黄红云1,2，张峰1,2，刘彦铖1,2，郗海涛1，王洪美1,2，任玉水1，周长满1,3   

  1. 1.北京市虹天济神经科学研究院，北京市 100144；2.北京康复中心神经外科，北京市 100144；3.北京大学基础医学院人体解剖与组织胚胎系，北京市 100083。
  • 收稿日期:2009-10-29 修回日期:2010-01-08 出版日期:2010-02-25 发布日期:2010-02-25
  • 通讯作者: 黄红云

Preliminary Result of Olfactory Ensheathing Cell Transplantation in Intractable Neuropathic Pain Following Spinal Cord Injury: 17 Cases Report

CHEN Lin, JIANG Zhao, HUANG Hong-yun, et al.   

  1. Beijing Hongtianji Neuroscience Academy, Department of Neurosurgery, Beijing Rehabilitation Center, Beijing 100144, China
  • Received:2009-10-29 Revised:2010-01-08 Published:2010-02-25 Online:2010-02-25

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被引次数

33

摘要： 目的探讨嗅鞘细胞移植对脊髓损伤后顽固性神经性疼痛的治疗效果。方法对细胞学治疗后获得疗效的脊髓损伤合并顽固性神经性疼痛患者的临床资料进行总结。2004年11月～2007年11月间的17例患者，其中男性15例，女性2例，年龄18～68岁，平均40.4岁。受伤6～312个月，平均105.9个月，受伤原因包括车祸、坠落、放射性损伤、机器挤压伤、枪伤、跳水。疼痛持续时间6～309个月，平均102.2个月。嗅球嗅鞘细胞胰蛋白酶消化成单细胞后培养12～14 d。细胞移植到损伤段的上下两端。疼痛评价使用国际神经修复学会脊髓损伤日常生活功能评价量表：0分为极度疼痛，止痛药无效；1分为中度疼痛，需用强效止痛药；2分为轻度疼痛，普通止痛药有效；3分为无疼痛。结果随访时间0.5～88个月，平均17.5个月，疼痛平均改善1.2分。结论嗅鞘细胞移植对脊髓损伤后神经性疼痛有一定治疗作用。

关键词: 嗅鞘细胞, 神经性疼痛, 中枢痛, 脊髓损伤, 脊髓内移植, 神经修复

Abstract: ObjectiveTo explore the feasibility and potential benefit of olfactory ensheathing cell (OEC) intraspinal transplantation in the treatment of intractable chronic neuropathic pain after spinal cord injury (SCI).Methods17 patients, 15 male and 2 female, with intractable chronic neuropathic pain after spinal cord injury was treated by OEC implant from November, 2004 to November, 2007. The age ranged from 18 to 68 (mean 40.4) years. The etiology of cord impairment included car accidents, falls, radiation damage, machine extrusion, gun-shot, and diving. The patients suffered severe persistent pain for 6 to 309 (mean 102.2) months, and the time points when cell therapy were administrated in the patients ranged from 6 to 312 (mean 105.9 months) after their injuries. Olfactory bulbs were harvested and trypsinized down to single fetal OECs. They were cultured for 12～14 days before implant. The fetal OECs were transplanted by injection into spinal cord at opposing ends of the injury site. The degree of pain was assessed and compared before operation and long-term follow-up according to the International Association of Neurorestoratology Spinal Cord Injury Functional Rating Scale (IANR-SCIFRS), i.e., 0 point means extreme pain, uncontrolled; 1 point, severe pain, narcotics required; 2 points, mild pain, ordinary pain killer effective; 3 points, no pain.ResultsThe follow-up and pain reevaluation were performed at 0.5 to 88 months with an average of 17.5 months after cell transplantation. The mean score of pain amelioration is 1.2 points.ConclusionThe OEC intraspinal transplantation appears to have a promising role in treatment of intractable chronic neuropathic pain after SCI.

Key words: olfactory ensheathing cell, neuropathic pain, central pain, spinal cord injury, intraspinal transplantation, neurorestoration