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目的:探讨脐带间充质干细胞(umbilical cord mesenchymal stem cells,UC-MSCs)移植治疗难治性系统性红斑狼疮(systemic lupus erythe matosus,SLE)的疗效和安全性。方法:40例难治性SLE随机分成两组,1组糖皮质激素加CTX治疗,2组在此基础上移植UC-MSCs,观察两组病例治疗前和治疗后2周、1个月、2个月、3个月、6个月、9个月、12个月的临床表现和实验室检查的变化。结果:治疗后2周患者SLEDAI评分降至<10分者1组12例(60%),2组18例(90%),两组比较差异有统计学意义(χ2=7.619,P=0.006);治疗1年后观察结果显示:PLT、ALB、C3均数2组较1组高(P<0.05),SLEDAI、U-Pro、ESR、hs-CRP 1组较2组高(P<0.05),WBC、Cr、C4两组差异无统计学意义(P>0.05);1组复发率为45%,2组15%,两组差异有统计学意义(χ2=4.286,P=0.038)。结论:难治性SLE在使用糖皮质激素加CTX治疗的基础上移植UC-MSCs安全、有效,但其远期疗效及不良反应有待进一步观察。
Objective: To investigate the efficacy and safety of umbilical cord mesenchymal stem cells (UC-MSCs) transplantation in the treatment of systemic lupus erythematosus (SLE). Methods: Forty patients with refractory SLE were randomly divided into two groups. One group received glucocorticoids plus CTX. Two groups were transplanted with UC-MSCs. The two groups were observed before treatment and after 2 weeks, 1 month, 2 months Months, 3 months, 6 months, 9 months, 12 months of clinical manifestations and laboratory changes. Results: After 2 weeks of treatment, the SLEDAI score was reduced to <10 in 12 patients (60%) in group 1 and 18 patients (90%) in 2 patients. The difference was statistically significant (χ2 = 7.619, P = 0.006) ; After one year of treatment, the results of observation showed that the average number of PLT, ALB and C3 in group 2 was higher than that in group 1 (P <0.05), and those in group SLEDAI, U-Pro, ESR and hs- There was no significant difference between WBC, Cr and C4 groups (P> 0.05). The recurrence rate was 45% in group 1 and 15% in group 2, the difference was statistically significant (χ2 = 4.286, P = 0.038). CONCLUSIONS: Refractory SLE is safe and effective in transplanting UC-MSCs on the basis of glucocorticoid plus CTX treatment. However, its long-term efficacy and adverse reactions need further observation.