中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (45): 8512-8515.doi: 10.3969/j.issn.1673-8225.2010.45.036

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

同一机构4年采用自体骨髓单个核细胞移植治疗严重下肢缺血56例1年随访

王  炜，刘长建，乔  彤，刘  晨，黄  佃   

  1. 南京大学医学院附属南京市鼓楼医院血管外科，江苏省南京市 210008
  • 出版日期:2010-11-05 发布日期:2010-11-05
  • 作者简介:王炜★，男，1974年生，江苏省南京市人，汉族，主治医师，2007年南京大学毕业，硕士，主要从事周围血管疾病的研究。 weiwangdoc@163.com

Autologous bone marrow mononuclear cells transplantation in treatment of severe lower limb ischemia in 56 cases in the same institute: One-year follow up

Wang Wei, Liu Chang-jian, Qiao Tong, Liu Chen, Huang Dian   

  1. Department of Vascular Surgery, Affiliated Drum Tower Hospital, Medical College of Nanjing University, Nanjing  210008, Jiangsu Province, China
  • Online:2010-11-05 Published:2010-11-05
  • About author:Wang Wei★, Master, Attending physician, Department of Vascular Surgery, Affiliated Drum Tower Hospital, Medical College of Nanjing University, Nanjing 210008, Jiangsu Province, China weiwangdoc@163.com.

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摘要：

背景：自体骨髓单个核细胞移植治疗下肢缺血已经在临床上取得了较满意的短期疗效，但缺少长期随访的报道，尤其对于已经出现严重下肢缺血症状的外周动脉疾病患者，相关的报道较少。
目的：观察自体骨髓单个核细胞移植治疗严重下肢缺血患者随访4周和1年时的疗效。
方法：自2005-01/2009-01收治56例59条严重下肢缺血患者。于患者髂骨抽取骨髓血300 mL，分离制备自体骨髓单个核细胞。移植部位从中下肢动脉主干闭塞处开始，按动脉行走的路径，将制成的干细胞悬液每隔1.0~2.0 cm注射1针，每次注射约1 mL，行下肢缺血肌肉局部移植。所有患者均采用单次移植治疗，单个核细胞总量为(0.31~29.46)×109，平均10.93×109。
结果与结论：所有患者均获随访1年。术后4周、1年的疼痛目测类比评分、最大行走距离、踝肱指数及经皮氧分压优于术前(P < 0.05)。术后1年血管造影显示新生侧支血管评估有效率28.8%(17/59)。所有患者移植后无任何并发症出现。

关键词: 严重肢体缺血, 自体骨髓单个核细胞, 移植, 外周动脉疾病, 长期随访

Abstract:

BACKGROUND: Autologous bone marrow mononuclear cell transplantation for treatment of lower limb ischemia has obtained satisfactory short-term curative effects, but lacks of long-term follow up. In particular, few reports have addressed peripheral artery disease patients with severe lower limb ischemia.
OBJECTIVE: To investigate the efficacy of autologous bone marrow mononuclear cells transplantation in treatment of severe lower limb ischemia in 4 weeks and 1 year follow up.
METHODS: From January 2005 to January 2009, 56 patients (59 limbs) with severe lower limb ischemia were treated. 300 mL bone marrow blood was extracted from patients’ ilium to separate and prepare autologous bone marrow mononuclear cells. The transplant part was from occlusion site of middle and lower extremity artery trunk. According to the way of arterial ambulation, stem cell suspension was made and injected once every 1.0-2.0 cm (each 1 mL). The local transplantation of lower limb ischemia muscle was performed. All patients received cell transplantation only once. The amount of transplanted bone marrow mononuclear cells was (0.31-29.46)×109 (mean 10.93×109).
RESULTS AND CONCLUSION: All patients were followed up for one year. After 4 weeks of implantation, the results of visual analogue scale, maximum walking distance, ankle brachial index, TcPO2 were superior at 4 weeks and 1 year following surgery compared with the preoperative results (P < 0.05). After one year of implantation, angiography revealed 28.8% (17/59) effective rate. No related complication was observed in patients after transplantation.

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