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目的探讨神经干细胞(neural stem cells,NSCs)移植治疗脑性瘫痪的疗效。方法对1例脑性瘫痪的患者进行静脉及椎管内NSCs移植。治疗方案:在30mins内将30ml含108～109数量的NSCs注入体内,共4次,每次间隔3～4d,第1,2,4次均为静脉注射,第3次为5mlNSCs椎管内注射+25ml静脉注射。分别于治疗前及治疗后60d对患儿进行韦氏儿童智力量表测评,日常生活活动能力指数(Barthel index,BI)及改良Ashworth痉挛评定量表评定。结果术后60d患儿肌张力下降,肢体活动能力提高,改良Ashworth痉挛评定量表由术前的Ⅱ级降至术后Ⅰ级,BI由术前的46分提高至69分,韦氏儿童智力测验无明显改善。结论NSCs治疗脑性瘫痪对本例患儿近期临床效果尚可,远期临床疗效有待进一步观察。
Objective To investigate the therapeutic effect of neural stem cells (NSCs) transplantation on cerebral palsy. Methods One case of cerebral palsy was treated by intravenous and intraspinal NSCs transplantation. Treatment regimen: Within 30mins 30ml containing 108 ~ 109 number of NSCs injected into the body, a total of 4 times, each interval of 3 ~ 4d, 1, 2, 4 are intravenous injection, the third is 5ml NSCs spinal injection + 25ml intravenous injection. The scores of Wechsler children’s intelligence scale, daily living activity index (BI) and modified Ashworth’s spasticity scale were assessed before treatment and 60 days after treatment. Results At 60 days after operation, the tension of the kidneys decreased and the limb mobility increased. The modified Ashworth Scale for Spasm decreased from preoperative grade Ⅱ to postoperative grade Ⅰ, and BI increased from 46 before preoperative to 69. No significant improvement in the test. Conclusion The treatment of cerebral palsy with NSCs has a good clinical effect in this patient. The long-term clinical effect remains to be further observed.