自体骨髓单个核细胞移植治疗42例严重慢性下肢缺血性疾病  

Autologous transplantation of bone marrow mononuclear cell in treating severe chronic lower extremity ischemia: a report of 42 cases

作　　者：辛世杰[1] 宋清斌[1] 胡海地[1] 张健[1] 秦岭峰[1] 张赞松[1] 张平[1] 罗英伟[1] 丁奎[1] 白明欣[1] 段志泉[1] 

机构地区：[1]中国医科大学附属第一医院普外三科,辽宁沈阳110001

出　　处：《中国医科大学学报》2006年第6期627-630,F0003,共5页Journal of China Medical University

基　　金：国家自然科学基金资助项目(30370551;30200276)

摘　　要：目的:评价自体骨髓单个核细胞移植治疗严重慢性下肢缺血性疾病的效果和安全性。方法:2003年12月至2005年12月应用自体骨髓单个核细胞移植术治疗42例严重慢性下肢缺血性疾病,其中下肢动脉硬化闭塞症(ASO)22例、血栓闭塞性脉管炎(TAO)5例、糖尿病足14例、下肢狼疮性动脉炎1例。术前多数患肢有轻重不同的静息痛,踝肱指数(ABI)均在0.6以下。随访时检查跛行距离、ABI、双下肢放射性核素扫描等客观指标。结果:患者手术1个月后开始随访,其中显著有效11例(26%)、有效16例(38%)、无效15例(36%),总有效率64%。糖尿病足、TAO、下肢狼疮性动脉炎3种疾病总有效率80%,ASO有效率50%,无手术并发症。结论:自体骨髓单个核细胞移植术能够增加患肢血流灌注,改善某些严重慢性下肢缺血性疾病的症状和体征。Objective： To evaluate the efficacy and safety of autologous implantation of bone marrow mononuclear cell （BM-MNC） in patients with severe chronic lower extremity isehemia. Methods： From December 2003 to December 20（0, we performed autologous transplantation of BM-MNC in 42 patients with severe chronic unilateral lower extremity ischemia,including 22 patients with arteriosclerosis obliterans （ASO） ,5 patients with thromboangiitis obliterans （TAO）, 14 patients with diabetes mellitus foot, and 1 patient with lower extremity lupus arteritis. Most patients suffered from rest pain,and the ankle-brachial indexes （ABI） of ischemic limbs were less than 0.6. The rest pain,painfree walking distance, ABI, and radioisotope scanning of lower extremities were determined during follow-up. Results： The total effective rate of autologous transplantation of BM-MNC was 64%,and the marked effective rate,effective rate,and ineffective rate was 26%（ 11/42）,38% （ 16/42）,and 36% （ 15/42）,respectively. The total effective rate of autologous transplantation of BM-MNC was 80% in patients with diabetes mellitus foot,TAO,and lower extremity lupus arteritis,and the effective rate was 50% in patients with ASO. No complication was found. Conclusion：Autologous transplantation of BM-MNC could increase blood flow of lower extremities and improve the sign and symptoms of severe chronic lower extremity ischemia.

关 键 词：骨髓单个核细胞 自体移植 慢性下肢缺血性疾病 双下肢放射性核素扫描 

分 类 号：R654.3[医药卫生—外科学]