中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (40): 7572-7575.doi: 10.3969/j.issn.1673-8225.2010.40.037

• 干细胞临床实践 clinical practice of stem cells • 上一篇    下一篇

自体外周血单个核细胞移植治疗下肢缺血27例

李环宇，胡何节，邓福生，王晓天，孙小杰   

  1. 安徽医科大学附属省立医院血管外科，安徽省合肥市  230001
  • 出版日期:2010-10-01 发布日期:2010-10-01
  • 通讯作者: 胡何节，硕士，主任医生，安徽医科大学附属省立医院血管外科，安徽省合肥市 230001 hu.hejie@163.com
  • 作者简介:李环宇★，男，1985年生，江西省萍乡市人，汉族，安徽医科大学附属省立医院血管外科在读硕士，主要从事血管外科方面的研究。 tonyli007007@163.com
  • 基金资助:

    安徽省卫生厅基金资助项目(2008A056)：严重下肢动脉闭塞的腔内微创治疗。

Autologous transplantation of peripheral blood mononuclear cells for lower limb ischemia in 27 cases

Li Huan-yu, Hu He-jie, Deng Fu-sheng, Wang Xiao-tian, Sun Xiao-jie   

  1. Department of Vascular Surgery, Anhui Provincial Hospital, Anhui Medical University, Hefei  230001, Anhui Province, China
  • Online:2010-10-01 Published:2010-10-01
  • Contact: Hu He-jie, Master, Chief physician, Department of Vascular Surgery, Anhui Provincial Hospital, Anhui Medical University, Hefei 230001, Anhui Province, China hu.hejie@163.com
  • About author:Li Huan-yu★, Studying for master’s degree, Department of Vascular Surgery, Anhui Provincial Hospital, Anhui Medical University, Hefei 230001, Anhui Province, China tonyli007007@163.com
  • Supported by:

    the Grant of Health Department of Anhui Province, No. 2008A056*

PDF

374

被引次数

7

摘要：

背景：下肢缺血性疾病的治疗经历了传统经典的旁路手术到现代腔内微创治疗的发展过程，但无论何种治疗方法都需要有良好的流出道，对于缺少动脉流出道、不能够耐受手术创伤的患者，动脉搭桥和腔内治疗都无能为力。
目的：观察经自体外周血单核细胞移植治疗下肢缺血的临床效果。
方法：纳入27例下肢缺血患者，细胞移植前均行计算机断层摄影血管造影提示远端流出道闭塞而不能行外科搭桥或腔内隔绝术。采取重组粒细胞集落刺激因子300 μg/d皮下注射，动员3 d后，应用血细胞分离仪3000Plus采集外周血单个核细胞注射于缺血患肢腓肠肌，3个月后随访观察患肢缺血的改善情况。
结果与结论：随访3~60个月，平均22个月，其各项指标均得到改善19例(70%)，无改善8例(30%)。主要观察指标包括患肢皮温、静息痛、间歇性跛行距离、麻木感、皮肤情况、踝/肱指数和经皮氧分压均得到明显改善。提示对于远端流出道完全闭塞的下肢缺血患者，自体外周血干细胞移植是一种安全、有效的治疗方法。

关键词: 外周血单核细胞, 细胞移植, 下肢, 缺血, 流出道

Abstract:

BACKGROUND: The treatment approach of lower limb ischemia from the traditional surgical bypass to now transluminal angioplasty needs better distal arterial outflow tract. Arterial bypass and endovascular treatment are unsuitable for the patients who are lack of arterial outflow tract and cannot bear surgical trauma.
OBJECTIVE: To observe the clinical outcome of autologous transplantation of peripheral blood mononuclear cells for treatment of lower limb ischemia.
METHODS: A total of 27 patients with lower limb ischemia, because of occluded outflow tract they cannot do bypass grafting and intracavitary angiopoiesis, were enrolled. The patients received subcutaneous injection of recombinant granulocyte colony-stimulating factor 300 μg/d. Following 3 days of mobilization, blood cell separator 3000Plus was used to collect peripheral blood mononuclear cells, which were injected into ischemic limbs gastrocnemius muscle. 3 months later, the improvement in affected limbs was observed.
RESULTS AND CONCLUSION: Follow-up was performed from 3 to 60 months, averagely 22 months. Each index was improved in 19 cases (70%), and not improved in 8 cases (30%). Main outcome measures including lower limb skin temperature, rest pain, intermittence claudication distance, insensible feeling, ulcers, ankle-brachial pressure index and transcutaneous oxygen pressure were significantly improved. These indicated that the autologous transplantation of peripheral blood stem cells represents a safe and effective therapeutic approach for lower limb ischemia with occluded outflow tract.

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