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目的建立猕猴局灶性血管缺血性脑损伤模型,评价自体骨髓间充质干细胞移植治疗脑损伤的疗效及临床治疗可行性。方法用导管介入法从股动脉将栓子输送至大脑中动脉使大脑中动脉分支动脉栓塞,诱发局灶性缺血性脑损伤,经CT扫描确认脑损伤及部位和行为学观察符合脑损伤要求。分离扩增自体骨髓间充质干细胞至第4代,于脑血管栓塞后30d,在CT引导下将4×108细胞/kg骨髓间充质干细胞移植到脑损伤部位,每月1次连续观察脑损伤面积及行为学变化。结果脑血管栓塞前造影明显可见左侧大脑中动脉血管树及其分支分布情况,栓塞后血管造影证实额颞区无血管显示,随后连续CT扫描见额颞叶区明显梗死灶,行为学观察可见血管栓塞对侧前后肢运动功能严重障碍。间充质干细胞移植后3个月可见脑损伤面积明显缩小,脑神经功能明显改善,半年后脑损伤面积进一步缩小,脑神经功能基本恢复正常。结论自体骨髓间充质干细胞移植有助于缺血性脑损伤结构修复和功能恢复。
Objective To establish a model of focal cerebral ischemia in cynomolgus monkey and evaluate the efficacy and clinical feasibility of autologous bone marrow mesenchymal stem cell transplantation for brain injury. Methods The embolus was delivered from the femoral artery to the middle cerebral artery via catheterization to embolize the branch artery of the middle cerebral artery to induce focal ischemic brain injury. The brain injury was confirmed by CT scanning and the site and behavioral observation was in accordance with the requirements of brain injury . After autologous bone marrow mesenchymal stem cells were isolated and expanded to the 4th generation, 30 × 108d after cerebral embolism, 4 × 108cells / kg bone marrow mesenchymal stem cells were transplanted to the brain injury site under CT guidance. The brain was continuously observed once a month Damage area and behavioral changes. Results Cerebral angiography showed obvious distribution of vascular tree and its branches in left middle cerebral artery. Embolization angiography showed that frontal-temporal vascular area showed no blood vessels. CT scan showed obvious frontal temporal lobe infarction, and behavioral observation showed that Vascular embolism before and after contralateral motor function of the serious obstacles. Three months after mesenchymal stem cell transplantation, the area of brain injury was significantly reduced, the function of cranial nerves was significantly improved, and the area of brain injury was further reduced after six months. The function of cranial nerves returned to normal. Conclusion Autologous bone marrow mesenchymal stem cells transplantation can contribute to the structural repair and functional recovery of ischemic brain injury.