摘要
目的初步探讨自体非清髓性造血干细胞移植(AHST)治疗1型糖尿病(T1DM)的有效性与安全性。方法首先,环磷酰胺及粒细胞集落刺激因子动员造血干细胞至外周血,采用白细胞分离术分离、处理造血干细胞并予以冻存;其次,采用环磷酰胺+兔抗胸腺细胞球蛋白方案预处理后,经静脉回输造血干细胞。观察移植前后胰岛素注射剂量、HbA1c水平、胰岛功能、胰岛自身抗体滴度等变化;记录治疗过程中及治疗后的不良反应。结果自回输干细胞后,(1)患者已停用胰岛素达15月余;(2)HbA1c降至7.0%以下;(3)胰岛功能较前明显改善;(4)未出现骨髓抑制、出血性膀胱炎等严重不良反应。结论AHST治疗T1DM一例,初步显示出一定的临床有效性,但仍需大样本量前瞻性研究,以进一步评估此疗法的远期疗效与安全性。
Objective To explore the efficacy and safety of autologous hematopoietic stem cell transplantation（AHST） in newly diagnosed type 1 diabetes mellitus. Methods Hematopoietic stem cells were mobilized with cyclophosphamide and granulocyte colonystimulating factor and then collected from peripheral blood by leukapheresis and cryopreserved. The cells were infused intravenously after conditioning with cyclophosphamide and rabbit antithymocyte globulin. To compare the daily dose Of exogenous insulin requirements, serum levels of hemoglobin A1c, islet β-cell function during the mixedmeal tolerance test, and anti-islet antibody titers were measured before and at different times following AHST. The adverse effects during and after AHST were recorded. Results The patient has been free from insulin for more than 9 months since AHST. Serum levels of hemoglobin A1c were maintained at less than 7 %, and islet β-cell function was greatly improved after AHST. There were no severe adverse effects such as myelosuppression and hemorrhagic cystitis. Conclusion： Very encouraging results are obtained in the patient treated with AHST. There is definite therapeutic effects and safety in a short-term. But further follow-up is necessary to confirm the duration of insulin independence and the mechanisms of action of the procedure.
出处
《中国糖尿病杂志》
CAS
CSCD
北大核心
2008年第9期554-556,共3页
Chinese Journal of Diabetes
关键词
糖尿病
1型
造血干细胞移植
疗效
Diabetes mellitus,type 1
Hematopoietic stem cell transplantation
Therapeutic effects
