关节内注射脐带血单个核细胞治疗膝骨关节炎△

Intra- articular injection of umbilical cord blood mononuclear cells for treatment of knee osteoarthritis

摘要:

［目的］ 探讨脐带血单个核细胞 （umbilical cord blood mononuclear cells, UCB-MNCs） 治疗膝关节骨关节炎 （knee os- teoarthritis, KOA）的临床疗效和安全性。［方法］2021 年 2 月—2022 年 9 月，30 例早、中期 KOA 患者接受膝关节腔内注射 2× 108 （3 ml）UCB-MNCs 治疗 2 次，间隔 1 个月。评估临床与影像资料。［结果］所有患者均顺利完成注射，主要不良反应为注射数天内关节肿胀和疼痛，但不影响关节功能活动。治疗前后血常规、血沉、C 反应蛋白以及肝功能、肾功能均无显著变化。随访 6 个月以上，随时间推移，患者疼痛和肿胀的 VAS 评分，以及 WOMAC 的疼痛、僵硬、功能、总体评分均显著降低（P<0.05）， 而 KOOS 各子项评分均显著提高（P<0.05）。影像方面，与治疗前相比，治疗 3 个月后 X 线片显示内侧、外侧和髌股室的 K-L 评级均无显著变化 （P>0.05）；内侧室 MOAKS 无显著变化 （P>0.05），而外侧室和髌股室 MOAKS 显著下降 （P<0.05）。［结论］ KOA 患者膝关节腔内注射 UCB-MNCs 治疗能有效缓解疼痛，改善功能。

Abstract:

[Objective] To explore the clinical efficacy and safety of intra-articular injection of umbilical cord blood mononuclear cells (UCB-MNCs) for treatment of knee osteoarthritis (KOA) . [Methods] From February 2021 to September 2022, 30 patients received intraven- tricular injection of 2×108 (3 ml) UCB-MNCs twice with one month apart for early- and mid-stage KOA. The clinical and imaging data were evaluated. [Results] All the patients had the injection completed successfully, with the main adverse reactions of joint swelling and pain with- in a few days after injection, whereas which not affected functional activities of the joint. There were no significant changes in blood routine, erythrocyte sedimentation, C-reactive protein, liver function and kidney function before and after treatment. As time went during the followup lasted for 6 months, the VAS scores for pain and swelling, as well as WOMAC pain, stiffness, function, and overall scores significantly de- creased (P＜0.05) , while all KOOS subscores significantly increased (P＜0.05) . Radiographically, the Kellgren-Lawrence grades in the medi- al, lateral and patellofemoral compartments remained unchanged (P＞0.05) , the MRI Osteoarthritis Knee Score (MOAKS) of the medial com- partment was not changed either (P＞0.05) , while the MOAKS scores of the lateral and patellofemoral compartments significantly decreased 3 months after treatment compared with those before treatment (P＜0.05) . [Conclusion] Intra-articular injection of UCB-MNCs for KOA does effectively relieve pain and improve function in this trial.