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《工程(英文)》 >> 2020年 第6卷 第10期 doi: 10.1016/j.eng.2020.02.006

间充质干细胞治疗人感染H7N9禽流感病毒所致急性呼吸窘迫综合征的临床研究——为新冠病毒肺炎救治提供新策略

a State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China

b The Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College, Hangzhou 310003, China

c Innovative Precision Medicine (IPM) Group, Hangzhou 311215, China

# These authors contributed equally to this work.

收稿日期: 2020-02-17 修回日期: 2020-02-21 录用日期: 2020-02-22 发布日期: 2020-02-28

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摘要

2013年,H7N9病毒在哺乳动物宿主之间迅速传播,并具有人与人之间传播的风险。患者表现为重症肺炎、急性呼吸窘迫综合征(acute respiratory distress syndrome, ARDS)和呼吸衰竭。间充质干细胞(mesenchymal stem cell, MSC)移植在病毒性肺炎的治疗中有广阔的前景,并于2013年作为应急性治疗方法来治疗H7N9感染的ARDS。该研究在单中心开展,为开放式临床研究。根据自愿和知情同意的原则,17例H7N9感染的ARDS患者移植同种异体经血来源的MSC作为治疗组,44例H7N9感染的ARDS患者作为对照组。与对照组相比,MSC移植显著降低了ARDS病死率(MSC治疗组和对照组死亡率分别为17.6%和54.5%)。此外,在对4名MSC移植患者进行为期5年的随访中,未发现MSC移植产生有害影响。总体而言,该研究结果表明MSC移植显著提高了H7N9感染的ARDS的存活率,并为开展临床前和临床应用MSC治疗H7N9感染的ARDS的研究提供了理论基础。由于H7N9和2019新型冠状病毒性肺炎(coronavirus disease 2019, COVID-19)临床表现相似(如ARDS和呼吸衰竭),并继发多器官功能障碍,因此基于MSC的疗法可能为COVID-19所致的ARDS患者获益。

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