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ENGLISH ABSTRACT
骨髓间充质干细胞治疗支气管胸膜瘘的研究进展
黄佩
高兴林
钟志成
陈文芳
王钰超
李静
作者及单位信息
·
DOI: 10.3760/cma.j.issn.1001-0939.2019.02.013
Bone marrow⁃derived mesenchymal stem⁃cell in treatment of bronchopleural fistula
Huang Pei
Gao Xinglin
Zhong Zhicheng
Chen Wenfang
Wang Yuchao
Li Jing
Authors Info & Affiliations
Huang Pei
Gao Xinglin
Zhong Zhicheng
Chen Wenfang
Wang Yuchao
Li Jing
·
DOI: 10.3760/cma.j.issn.1001-0939.2019.02.013
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摘要

支气管胸膜瘘(BPF)是病死率、致残率极高的疾病,随着呼吸内镜技术的发展,各式材料在治疗BPF富有极大的运用前景,包括封堵剂、气道支架、房间隔封堵器等,近年新兴的骨髓间充质干细胞(bone marrow-derived mesenchymal stem-cell,BMSC)因其多谱系分化能力、免疫原性弱等优点开始用于治疗BPF。而本文致力于系统阐述BMSC近年在BPF的治疗进展,以期对临床上治疗BPF提供帮助。

引用本文

黄佩,高兴林,钟志成,等. 骨髓间充质干细胞治疗支气管胸膜瘘的研究进展[J]. 中华结核和呼吸杂志,2019,42(2):137-140.

DOI:10.3760/cma.j.issn.1001-0939.2019.02.013

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支气管胸膜瘘(bronchopleural fistula,BPF)是指肺泡、各级支气管与胸膜腔之间相互交通而形成的瘘管,是外科手术治疗包括肺叶切除术、肺段楔形切除术的常见并发症之一,据报道其发生率约为0.3%~20% [ 1 ],与术前的新辅助放化疗、支气管残端癌残留、糖尿病、慢性阻塞性肺病等诸多因素相关 [ 2 , 3 ]。虽然随着医疗水平的不断提高,特别是近年对BPF认识的加深、围手术期管理的加强以及高效抗生素的应用,使得BPF的发生率有所降低,但是其致死率仍达15%~80% [ 4 ]。其治疗首选方式为外科手术,但部分患者因处于肿瘤晚期或者合并严重的感染,一般情况较差,无法耐受手术。而自1977年Hartmann和Rausch [ 5 ]及Ratliff等 [ 6 ]分别报道组织胶和铅塞(Lead plug)在内镜下成功治疗BPF后,内镜治疗BPF迅猛发展,其治疗方式可选择硬化剂、封堵剂、线圈、气道支架、封堵器等多种介入手段 [ 7 , 8 , 9 , 10 ]。随着近年干细胞生物学研究的深入,与肺相关干细胞/祖细胞在肺发育和损伤修复的认识也在不断加深。基于此,有学者提出了细胞治疗BPF的概念。Petrella等 [ 11 ]通过外科手术切除右肺上叶制作BPF的山羊模型,在动物水平上验证了BMSC在BPF的治疗效果,而后又于2015年在《新英格兰医学杂志》报道在支气管镜直视下注射BMSC成功封堵BPF的病例报道 [ 12 ],之后其他研究者相继报道BMSC成功治疗BPF的病例。当前,BMSC在治疗BPF上显示出令人鼓舞的效果。
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