自体骨髓干细胞移植对老年下肢缺血疾病的疗效.docVIP

自体骨髓干细胞移植对老年下肢缺血疾病的疗效 作者：吕晓霞 尹至 金 星 吴学君 侯向前 李亚南2 作者单位：(山东大学附属省立医院，山东 济南 250021) 【摘要】 目的 评价干细胞移植治疗慢性下肢缺血的临床疗效及相关影响因素。方法 应用自体骨髓干细胞移植治疗34例老年慢性下肢缺血患者。其中下肢动脉硬化闭塞症27例，糖尿病足7例。用梯度密度法分离骨髓干细胞，制备干细胞悬液。直接注射至患肢肌肉内。结果 患肢疼痛、麻木感和冷感觉改善率为79.41%，术后第1天患者即反映患肢不适感好转。出院时,27例患者静息痛消失或明显减轻，3例患者跛行距离由不足50 m提高到大于100 m，6例伴有溃疡患者，溃疡愈合或面积逐渐减小，6例踝肱指数(ABI)增加大于0.1，4例足趾坏疽患者中：1例症状明显缓解，静息痛消失，行坏疽足趾切除，愈合良好，2 例疼痛消失，睡眠改善，坏疽组织有脱落迹象，1例于膝下截肢时被截除。结论 干细胞移植治疗慢性下肢缺血，方法安全、简单、有效。尤其是对于下肢动脉没有流出道的患者,可使一部分患者免除截肢或降低截肢平面,改善生活质量。 【关键词】 自体骨髓干细胞移植;下肢缺血;治疗性血管生成 Therapeutic effect of autologous bone marrow stem cells transplantation on aged patients with chronic ischemia of lower limb 　　L? XiaoXia, YIN Zhi, JIN Xing, et al. 　　Department of Vascular Surgery, Shandong Provincial Hospital, Ji′nan 250001, Shandong, China 　　【Abstract】 Objective To evaluate the effect of autologous on bone marrow stem cells (BMSC) transplantation in aged patients with chronic ischemia of lower limb and explore relative influence factors. Methods 34 aged patients with chronic ischemia of lower limb were treated with autologus BMSC transplantation, including 27 cases of atherosclerosis obliteran (ASO), 7 cases of diabetic feet. BMSC were isolated with density gradient centrifugation and were intramuscularly injected into the suffered limbs. Results The symptoms of pain, paresis, and coldness were improved by 79.41%. The rest pain of 27 paitents diminished or relieved obviously. The distance of intermittent claudication was increased from less than 50 m to more than 100 m in 3 patients. The ulcers of 6 patients healed up or reduced in size. The ankle brachial index (ABI) increased by more than 0.1 in 6 patients. Among the 4 patients with toes gangrene, 1 patient got rid of the rest pain and had a good wound healing after the gangrenous toes resection, 2 patients got rid of the pain and the gangrenous tissue began to exfoliate, 1 patient was subjected to a belowknee amputation. Conclusions The autologus BMSC transplantatio