摘要
目的:探讨自体骨髓干细胞移植治疗下肢血栓闭塞性脉管炎(TAO)的疗效。方法:选取2010年3月-2011年5月间在华中科技大学同济医学院附属协和医院施行骨髓干细胞移植治疗血栓闭塞性脉管炎的14例患者(患肢20例)进行回顾分析。治疗手段为髂前上棘抽取自体骨髓单个核细胞,于患肢肌注移植,并在术后辅助抗血小板和扩血管的抗血栓治疗。6个月后随访,随访内容包括主观症状(疼痛,冷感,麻木)以及客观指标(踝肱指数ABI,经皮氧分压TcPO2,血管数字减影造影DSA,足部溃疡,跛行距离)。根据以上随访内容判断疗效。结果:治疗后6个月,所有患者均得到随访。记录随访内容,有18例患肢疼痛缓解,19例患肢冷感减弱或消失,13例患肢麻木感缓解。客观指标上,治疗前所有患者均测量了ABI,ABI在(0.39 0.15)范围内,6个月随访测得ABI为(0.49 0.26),差异有统计学意义(P<0.05)。治疗前TcPO2为(25.12 4.24)mmHg,治疗后升高,为(33.20 6.45)mmHg(P<0.05)。侧支循环再生度评分,显效1例、良好3例、改善10例、无效6例、恶化0例,有效率达到70%,侧支再生度评分治疗前(1.37 0.91),治疗后(2.32 0.69),较之前明显丰富(P<0.01)。溃疡改善患肢8例。跛行距离,显效0例、良好4例、改善9例、无效5例、恶化2例,有效率65.0%。结论:自体骨髓干细胞移植治疗下肢血栓闭塞性脉管炎的疗效确切,可以有效控制症状并促进溃疡的愈合。
Objective：To investigate the effect and safety of autologous bone marrow-mononuclear cell（BM-MNC） transplantation on ischemic limb of patients with thromboangiitis obliterans（TAO）.Methods：Fourteen patients with TAO underwent transplantation of autologous BM-MNC into ischemic muscles of 20 lower limbs.A series of subjective indexes（improvement of pain and cold sensation） and objective indexes including increase of ankle brachial index （ABI）,transcutaneous oxygen pressure（TcPO2）,and improvement of foot skin ulcer were used to evaluate the effects.Results：The outcomes were evaluated after 6 months of transplantation.The pain relief and improvement of cold feeling were in 18 limbs and 19 limbs,respectively.Before transplantation and 6 months after transplantation,ABI was（0.39±0.15） and（0.49±0.26）,respectively（P0.05）,and TcPO2 of the ischemic legs were（25.12±4.24） mm Hg（1 mm Hg=0.133 kPa） and （33.20±6.45） mm Hg,respectively（P0.05）.The ischemic symptoms in 8 patients were not relieved.There was no mortality and high level amputation.The following complications,such as proliferative retinopathy,malignant tumor,myocardial infarction,stroke or hemangioma,were not found in all patients.Conclusion：In patients with TAO,intramuscular transplantation of autologous BM-MNC is a safe and effective method,and may improve symptoms and accelerate the healing of skin ulcer.
出处
《中国医药导刊》
2012年第12期2170-2171,共2页
Chinese Journal of Medicinal Guide
关键词
自体骨髓干细胞移植
血栓性脉管炎
踝肱指数
经皮氧分压
Autologous bone marrow-mononuclear cells
Thromboangiitis obliterans
Ankle brachial index
Transcutaneous oxygen pressure
