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目的:观察脐带间充质干细胞(umbilical cord mesenchymal stem cells,UC-MSCs)移植治疗狼疮性肾炎(lupus nephritis,LN)的临床效果。方法:UC-MSCs移植治疗20例LN患者,每例患者移植3×107个MSCs 2次,观察患者移植前及移植后2周、1、2、3、6、9、12个月的临床表现和实验室指标的变化。结果:随访12个月,1例患者失访,移植后1个月内患者SLE疾病活动度指数(SLEDAI)、尿蛋白(U-Pro)、血沉、高敏C反应蛋白、血肌酐明显下降,白蛋白、补体C3、补体C4升至正常,与移植前比较差异有统计学意义(P<0.05),移植后1~6个月上述指标较稳定,移植后9~12个月SLEDAI、U-Pro数值有所回升,但仅2例复发,与移植前比较差异仍有统计学意义(P<0.05);移植前后白细胞、血小板差异无统计学意义(P>0.05);移植中患者无不适,随访期间未发现移植相关并发症。结论:UC-MSCs移植治疗难治性SLE、LN能明显改善病情,复发率低,到目前为止未发现不良反应,但由于随访时间有限,故其疗效及副作用有待进一步研究。
Objective: To observe the clinical effect of umbilical cord mesenchymal stem cells (UC-MSCs) transplantation in the treatment of lupus nephritis (LN). Methods: UC-MSCs were transplanted in 20 patients with LN. Each patient was transplanted with 3 × 107 MSCs twice. The clinical manifestations were observed before transplantation and 2 weeks, 1, 2, 3, 6, 9 and 12 months after transplantation And laboratory indicators of change. Results: At the 12-month follow-up, 1 patient was lost to follow-up and the SLE disease activity index (SLEDAI), urinary protein (U-Pro), ESR, high sensitivity C-reactive protein and serum creatinine were significantly decreased The protein, complement C3 and complement C4 increased to normal, which was significantly different from that before transplantation (P <0.05). The indexes above were stable from 1 to 6 months after transplantation. The SLEDAI, U-Pro There was no significant difference between pre-transplant and post-transplant leukocyte and platelet count (P> 0.05). There was no discomfort and follow-up in patients During the transplant-related complications were not found. CONCLUSION: UC-MSCs transplantation can effectively improve the condition of patients with refractory SLE. LN has low recurrence rate and no adverse reaction so far. However, the curative effect and side effects of UC-MSCs need further study because of limited follow-up time.