脐带间充质干细胞治疗产褥期终末期肾病的长期结局
Long-Term Outcomes of Umbilical Cord Mesenchymal Stem Cell Therapy for End-Stage Renal Disease in the Puerperium
摘要: 本文报道一例43岁产褥期慢性肾功能不全尿毒症期(CKD IV期)患者接受自体脐带间充质干细胞(UC-MSCs)治疗并行长达13年(2012~2025)随访的病例。病史特征：患者有20余年IgA肾病病史，2011年进展至CKD IV期并开始维持性透析；2012年妊娠期间肾功能急性加重，于孕32周行剖宫产术终止妊娠，术中留取脐带组织。治疗方法：产后予以共五次自体UC-MSCs静脉输注治疗(剂量：1 × 107 cells/次)，输注过程顺利，未发生发热、过敏或其他不良事件。短期疗效：治疗后短期观察显示，部分肾功能指标(如Scr、BUN)曾出现一定性改善。长期转归：经13年随访，患者维持规律透析(3次/周，未较前增加)，肾功能衰退速率减缓，远期并发症(如肾性骨病、心血管事件)出现时间延迟、程度减轻，生活质量保持稳定。结论意义：本案例表明UC-MSCs输注用于产褥期ESRD患者安全性良好，且可能延缓疾病进展，为该类特殊人群的治疗提供了新思路与临床参考。
Abstract: This case report describes a 43-year-old puerperal patient with end-stage renal disease (ESRD; CKD stage IV) who underwent autologous umbilical cord mesenchymal stem cell (UC-MSC) therapy and was followed up for 13 years (2012~2025). Medical history: The patient had a 20-year history of IgA nephropathy, progressed to CKD stage IV in 2011, and initiated maintenance dialysis. During pregnancy in 2012, she experienced acute renal function deterioration, prompting cesarean delivery at 32 weeks of gestation, during which umbilical cord tissue was collected. Treatment: Postpartum, the patient received five intravenous infusions of autologous UC-MSCs (1 × 107 cells per infusion). The procedure was well-tolerated without adverse events such as fever, allergic reactions, or other complications. Short-term outcomes: Short-term post-treatment monitoring showed transient improvement in certain renal function parameters, including serum creatinine (Scr) and blood urea nitrogen (BUN). Long-term outcomes: After 13 years of follow-up, the patient maintained regular dialysis (3 sessions/week, without frequency increase), exhibited slowed progression of renal function decline, and experienced delayed onset and reduced severity of long-term complications (e.g., renal osteodystrophy and cardiovascular events), with preserved quality of life. Conclusion: This case suggests that UC-MSC infusion is safe and may delay disease progression in puerperal patients with ESRD, offering novel insights and clinical references for managing this special population.
文章引用：龚熙媛, 包晗, 周娟, 罗惠娟, 肖小敏, 汤小湄. 脐带间充质干细胞治疗产褥期终末期肾病的长期结局[J]. 临床医学进展, 2025, 15(9): 1217-1225. https://doi.org/10.12677/acm.2025.1592613

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