中国组织工程研究

中国组织工程研究 ›› 2015, Vol. 19 ›› Issue (41): 6671-6676.doi: 10.3969/j.issn.2095-4344.2015.41.020

• 干细胞移植 stem cell transplantation • 上一篇    下一篇

自体骨髓干细胞移植治疗动脉硬化闭塞症：7年结局评价

白  超，田  野，罗  军   

  1. 新疆医科大学第一附属医院血管甲状腺外科，新疆维吾尔自治区乌鲁木齐市  830054
  • 出版日期:2015-10-01 发布日期:2015-10-01
  • 通讯作者: 罗军，博士，主任医师，新疆医科大学第一附属医院血管甲状腺外科，新疆维吾尔自治区乌鲁木齐市 830054
  • 作者简介:白超，男，1981年生，新疆维吾尔自治区乌鲁木齐市人，汉族，2009年新疆医科大学毕业，硕士，主治医师，主要从事血管及甲状腺相关疾病方向的研究。
  • 基金资助:

    新疆维吾尔自治区自然科学基金资助项目(2010211A48)

Autologous bone marrow stem cell transplantation for arteriosclerosis obliterans: a 7-year outcome evaluation

Bai Chao, Tian Ye, Luo Jun   

  1. Department of Thyroid Surgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
  • Online:2015-10-01 Published:2015-10-01
  • Contact: Luo Jun, M.D., Chief physician, Department of Thyroid Surgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
  • About author:Bai Chao, Master, Attending physician, Department of Thyroid Surgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
  • Supported by:

    the Natural Science Foundation of Xinjiang Uygur Autonomous Region, No. 2010211A48

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摘要：

背景：随着传统外科技术和血管腔内治疗技术的进步，下肢动脉硬化闭塞症的治疗效果得到提高，但其长期预后情况仍不明确，所以其治疗一直是血管外科的难题。
目的：观察自体骨髓干细胞移植治疗下肢动脉硬化闭塞症的长期临床疗效。
方法：自2007年9月至2013年7月接受自体骨髓干细胞移植治疗的39例动脉硬化闭塞症患者，共行自体骨髓干细胞移植56次。随访截止时间为2015年2月，随访时间共7年6个月余，治疗后每年定期电话随访患肢疼痛、冷感、间歇性跛行距离、静息状态下踝肱指数和患肢溃疡的面积和深度，治疗后1年复查患肢动脉造影和静脉血气分析。
结果与结论：39例患者有4例患者因疗效不佳截肢，2例患者因急性心肌梗死死亡，2例患者未及时截肢死亡，随访3年以上者共31例。治疗后疼痛、冷感和间歇性跛行距离较治疗前有所好转，且随着治疗时间的推移，上述情况逐步好转，差异均有显著性意义；治疗后踝肱指数较治疗前增大，差异有显著性意义；治疗后患肢溃疡面积和深度变小，与治疗前相比，差异有显著性意义；治疗前和治疗后1年患肢静脉血氧分压、血氧饱和度对比差异有显著性意义，治疗后毛细血管条数明显增多。结果表明自体骨髓干细胞移植是一种治疗下肢动脉硬化闭塞症的安全方法，其远期疗效良好、稳定，对于血管条件差、传统方法疗效欠佳者，可选用此方法。
中国组织工程研究杂志出版内容重点：干细胞；骨髓干细胞；造血干细胞；脂肪干细胞；肿瘤干细胞；胚胎干细胞；脐带脐血干细胞；干细胞诱导；干细胞分化；组织工程

关键词: 干细胞, 移植, 下肢动脉硬化闭塞症, 自体骨髓干细胞, 踝肱指数, 新疆维吾尔自治区自然科学基金

Abstract:

BACKGROUND: With the development of surgical techniques and endovascular treatment techniques, the therapeutic efficacy on arteriosclerosis obliterans of the lower limbs has been improved greatly. As the long-term prognosis is still not clear, how to treat arteriosclerosis obliterans of the lower limbs is still a problem for vascular surgery.
OBJECTIVE: To observe the long-term clinical efficacy of autologous bone marrow stem cell transplantation in the treatment of arteriosclerosis obliterans of the lower limbs. METHODS: Thirty-nine patients with arteriosclerosis obliterans who had undergone autologous bone marrow mesenchymal stem cells (totally 56 times of cell transplantation) from September 2007 to July 2013 were enrolled in this study. As of February 2015, the follow-up time was 7.5 years. After treatment, regular telephone follow-up about limb pain, cold sensation, intermittent claudication distance, resting ankle-brachial index and limb ulcer size and 
depth was done annually; at 1 year after treatment, limb arteriography and venous blood gas analysis were reviewed.
RESULTS AND CONCLUSION: Of the enrolled 39 patients, 4 patients were subjected to amputation because of poor efficacy, 2 patients died of acute myocardial infarction, and 2 patients died of not timely amputation. There were 31 patients who had been followed up for over 3 years. After treatment, the resting ankle-brachial index and limb ulcer size and depth limb pain were both improved significantly. There were significant differences in 1-year limb blood oxygen partial pressure and oxygen saturation before and after treatment, and the postoperative number of capillaries also increased significantly. These findings indicate that autologous bone marrow stem cell transplantation is a safe treatment for arteriosclerosis obliterans of the lower limbs with better and stable long-term curative effects. This method is a good choice for patients who have poor blood vessels and poor efficacy of traditional methods.
中国组织工程研究杂志出版内容重点：干细胞；骨髓干细胞；造血干细胞；脂肪干细胞；肿瘤干细胞；胚胎干细胞；脐带脐血干细胞；干细胞诱导；干细胞分化；组织工程

Key words: Myeloid Progenitor Cells, Stem Cell Transplantation, Arteriosclerosis Obliterans, Tissue Engineering