Ischemic Stroke
Conditions
Brief summary
This study is to evaluated the safety and efficacy of BMSCs transplantation in the treatment of ischemic stroke, so as to provide a basis for future clinical application of BMSCs transplantation in the treatment of ischemic stroke.
Detailed description
1. Routine treatment: 1.1. If arterial plaque is found, use lipid-lowering therapy (routine dose of atorvastatin or rosuvastatin). If no plaque is found, use atorvastatin or rosuvastatin based on the maintenance of normal blood lipid; 1.2. If venous thrombosis or arterial plaques are found in the lower limbs, use dabigatran to prevent platelet aggregation; if no vascular problems are found in the lower limbs, use aspirin or clopidogrel to prevent platelet aggregation; 1.3. During the treatment, cerebrovascular stenosis (non responsible vessels) can be treated intravascularly; 1.4. The use of neurotrophic drugs is prohibited during the study; 1.5. Elevated homocysteine was treated with mecobalamin and folic acid; 1.6. Hypertension, diabetes and other basic diseases receive routine treatment, and the combined medication is recorded in the case report form. 2. Grouping: 2.1. BMSCs group: BMSCs were transplanted on the basis of routine treatment: the transplanted cells were injected intravenously and transplanted in two times, with a dose of 1 × 106 / kg body weight, each volume of 80ml ± 5ml, and the time interval between two transplants was 1 week; 2.2. Routine treatment group: only receiving routine treatment;
Interventions
Bone marrow was collected, cultured in vitro and injected back into the body
Sponsors
Study design
Eligibility
Inclusion criteria
1. Patients aged 18-65 years old in the rehabilitation period of cerebral infarction (including subacute stage, chronic stage and sequelae stage, with onset time ≤ 3 years), regardless of gender; 2. Definite cerebral infarction in the blood supply area of middle cerebral artery confirmed by imaging; 3. There are clear neurological deficits, such as motor and cognitive dysfunction (National Institutes of Health Stroke Scale 7 \< NIHSS \< 21 points); 4. Those who agree to take effective contraceptive measures during the study period, and women of childbearing age have negative pregnancy test; 5. Sign the informed consent of the patient and agree to participate in all visits, examinations and treatments as required by the study protocol.
Exclusion criteria
1. Lacunar cerebral infarction; 2. Acute cerebral infarction, onset time \< 2 weeks; 3. Mild ischemic stroke or mild neurological impairment or severe ischemic stroke, with coma; 4. Patients with moyamoya disease, vascular malformation, hemangioma and carotid stenosis exceeding 70%; 5. Patients with severe heart valve disease or confirmed intractable atrial fibrillation; 6. Complicated with intracranial hemorrhage or tumor; 7. Patients with cerebral infarction caused by blood system diseases, or those with previous blood history or family history of blood diseases; 8. Any one of 5 items of hepatitis B virus (HBsAg, HBsAb, HBeAg, HBeAb, HBcAb), hepatitis C virus (HCV) antibody, human immunodeficiency virus (HIV) antibody and syphilis spiral physical examination; 9. Those with severe respiratory or circulatory system or liver and kidney dysfunction who cannot tolerate treatment and examination; 10. Severe febrile disease or viral disease in the past 12 weeks; 11. Malignant tumor; 12. Those who have a previous history of autoimmune diseases or a family history of autoimmune diseases; 13. Previous history of drug allergy; 14. Pregnant or lactating women; 15. Those who are participating or have participated in this study or participated in other clinical trials within 12 weeks before enrollment; 16. Other circumstances that the investigator considers inappropriate for participation in this study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The difference in National Institutes of Health Stroke Scale (NIHSS) score from baseline after the first transplant. | 96 weeks ±30 days after the first transplantation | The difference in National Institutes of Health Stroke Scale (NIHSS) score from baseline at week 96 ±30 days after the first transplant. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Improvement rate of the modified Barthel Index Rating Scale score from baseline after the first transplant | 48 weeks ±15 days after the first transplantation | Improvement rate of the modified Barthel Index Rating Scale score from baseline at 48 weeks ±15 days after the first transplantation |
| Improvement rate of the modified Barthel Index Rating Scale score from baseline | 96 weeks ±30 days after the first transplantation | Improvement rate of the modified Barthel Index Rating Scale score from baseline at 96 weeks ±30 days after the first transplant |
| Improvement rate of Fugl-Meyer scale score from baseline after the first transplantation | 48 weeks ±15 days after the first transplantation | Improvement rate of Fugl-Meyer scale score from baseline at 48 weeks ±15 days after the first transplantation |
| Improvement rate of Simple Mental State Examination Scale (MMSE) score | 48 weeks ±15 days after the first transplantation | Improvement rate of Simple Mental State Examination Scale (MMSE) score from baseline at 48 weeks ±15 days after the first transplantation |
| The time course of the left abductor pollicis brevis and right abductor pollicis brevis of the motor evoked potential decreased from baseline after the first transplantation | 48 weeks ±15 days after the first transplantation | The time course of the left abductor pollicis brevis and right abductor pollicis brevis of the motor evoked potential decreased from baseline at 48 weeks ±15 days after the first transplantation |
| The difference from baseline in National Institutes of Health Stroke Scale (NIHSS) score after the first transplantation | 48 weeks ±15 days after the first transplantation | The difference from baseline in National Institutes of Health Stroke Scale (NIHSS) score at 48 weeks ±15 days after the first transplantation |
| The time course of the upper limb sensory evoked potential N9(left), N11(left), N20(left), N9(right), N11(right), N20(right) decreased from baseline after the first transplantation | 48 weeks ±15 days after the first transplantation | The time course of the upper limb sensory evoked potential N9(left), N11(left), N20(left), N9(right), N11(right), N20(right) decreased from baseline at 48 weeks ±15 days after the first transplantation |
| Rate of increase from baseline amplitude of the upper limb sensory evoked potential N9(left), N11(left), N20(left), N9(right), N11(right), N20(right) after the first transplantation | 48 weeks ±15 days after the first transplantation | Rate of increase from baseline amplitude of the upper limb sensory evoked potential N9(left), N11(left), N20(left), N9(right), N11(right), N20(right) at 48 weeks ±15 days after the first transplantation |
| Changes in CTA from baseline after the first transplantation | 48 weeks ±15 days after the first transplantation | Changes in CTA from baseline at 48 weeks ±15 days after the first transplantation |
| Changes in CTP from baseline after the first transplantation | 96 weeks ±30 days after the first transplantation | Changes in CTP from baseline at 96 weeks ±30 days after the first transplantation |
| Changes in mRS Scores from baseline after the first transplantation | 48 weeks ±15 days after the first transplantation | Changes in mRS Scores from baseline at 48 weeks ±15 days after the first transplantation |
| MT increase rate from baseline in the left abductor Pollicis brevis and right abductor pollicis brevis of the motor evoked potential after the first transplantation | 48 weeks ±15 days after the first transplantation | MT increase rate from baseline in the left abductor Pollicis brevis and right abductor pollicis brevis of the motor evoked potential at 48 weeks ±15 days after the first transplantation |
Countries
China