中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (45): 8508-8512.doi: 10.3969/j.issn.1673-8225.2011.45.033

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

自体干细胞移植治疗糖尿病足的干细胞动员和采集

李  华，陈旭艳，周  斌，冯亮华，肖萍萍，吴完婷   

  1. 福建医科大学教学医院厦门市第二医院血液科，福建省厦门市361021
  • 收稿日期:2011-04-21 修回日期:2011-06-21 出版日期:2011-11-05 发布日期:2011-11-05
  • 作者简介:李华★，女，1978年生，江苏省徐州市人，汉族，2006年兰州大学毕业，硕士，主治医师，主要从事血液内科和干细胞治疗工作。 Lihua361021@126.com
  • 基金资助:

    2009年厦门市第二医院青年科研基金项目(YQN2009001)，课题名称“外周血干细胞移植治疗糖尿病足的临床研究”。

Stem cell mobilization and collection for autologous peripheral blood stem cells transplantation in diabetic foot treatment

Li Hua, Chen Xu-yan, Zhou Bin, Feng Liang-hua, Xiao Ping-ping, Wu Wan-ting   

  1. Department of Hematology, Fujian Medical University Teaching Hospital, Second Hospital of Xiamen City, Xiamen  361021, Fujian Province, China
  • Received:2011-04-21 Revised:2011-06-21 Online:2011-11-05 Published:2011-11-05
  • About author:Li Hua★, Master, Attending physician, Department of Hematology, Fujian Medical University Teaching Hospital, Second Hospital of Xiamen City, Xiamen 361021, Fujian Province, China Lihua361021@126.com
  • Supported by:

    the Youth Science and Technology Foundation of Second Hospital of Xiamen City in 2009, No. YQN2009001*

PDF

391

被引次数

22

摘要：

背景：在自体干细胞移植治疗下肢缺血性疾病的干细胞动员期间，国内外大多数研究组均常规应用5~10 μg/(kg•d)的粒细胞集落刺激因子动员，5 d后采集干细胞进行移植，这是否为最佳的动员时间和采集时机未见相关报道。
目的：分析探讨自体干细胞移植最佳动员方案及采集时机，提高该方法的安全性。
方法：对备行干细胞移植的18例糖尿病足患者分别采用粒细胞集落刺激因子5，10 μg/(kg•d)进行造血干细胞动员，分析粒细胞集落刺激因子动员天数、剂量与外周血白细胞、单个核细胞、CD34+细胞数的关系，并检测干细胞动员前后、采集前后患者凝血指标、血小板计数的变化，观察患者动员及采集过程的不良反应。
结果与结论：随着动员天数的增加，白细胞和单个核细胞、CD34+细胞数也随之增加，干细胞获得的效率与粒细胞集落刺激因子的剂量、动员时间有关，外周血中CD34+总数与单个核细胞总数呈正相关。患者的凝血指标在动员和采集前后无显著变化。血小板计数在动员前后无变化，但在采集后有显著下降；18例患者中仅有1例在粒细胞集落刺激因子动员中发生轻度骨头酸痛，1例出现发热，其他患者均无不良反应发生。提示，糖尿病足患者干细胞采集的最佳时机不能单凭动员天数和外周血白细胞数决定，而是由外周血单个核细胞数和CD34+的数量来决定。且干细胞动员和采集对患者的不良反应小，安全性高。

关键词: 粒细胞集落刺激因子, 造血干细胞, 动员, 安全性, 糖尿病

Abstract:

BACKGROUND: Autologous stem cell transplantation in the treatment of lower limb ischemia has been developed extensively in domestic and overseas and achieved better clinical curative effect. 5-10 μg/(kg • d) of granulocyte colony-stimulating factor (G-CSF) mobilization is often used, and stem cells are harvested after 5 days for transplantation. Whether the above-mentioned is the optimal mobilization scheme and harvesting opportunity is not reported.
OBJECTIVE: To explore the best mobilizing scheme and harvesting opportunity and to increase the security of the treatment.
METHODS: Eighteen diabetes foot patients preparing for stem cell transplantation were enrolled. G-CSF of 5-10 μg/(kg • d) was used for mobilizing hematopoietic stem cells. The relations between mobilization dose and days of G-CSF and the numbers of WBC, peripheral single nuclear cells and CD34+ were analyzed. Coagulation indexes and platelet count were detected before and after mobilization and collecting. Patients’ adverse effects were observed during process of acquisition and mobilization.
RESULTS AND CONCLUSION: The acquisition efficiency of stem cells was closely related to mobilization dose and days of G-CSF. There were no significant changes in coagulation indexes before and after mobilization and collecting. Platelet count had no change before and after mobilization, but dropped dramaticlly after collecting .There was only one patient with mild bone ache and one patient who had a fever during the mobilization. Other patients all had no obvious adverse effects. The optimal time of stem cell collecting for patient with diabetic foot is decided by the number of peripheral blood mononuclear cells and CD34+ cells, not only by mobilization days and white blood cells counts. Mobilization and collecting of stem cells has a smaller effect on patients and a higher security.

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