自体骨髓干细胞移植治疗下肢动脉缺血性疾病的疗效观察  

Clinical efficacy and influcing factors of autologous transplantation of bone marrow mononuclear cells in the treatment of lower extremity ischemic disorders

作　　者：侯向前[1] 吴学君[1] 张精勇[1] 金星[1] 吕晓霞[1] 钟振岳[1] 张十一[1] 董典宁[1] 孙岩[1] 

机构地区：[1]山东大学山东省立医院血管外科,山东济南250021

出　　处：《中国现代普通外科进展》2007年第4期320-323,共4页Chinese Journal of Current Advances in General Surgery

基　　金：高等学校博士学科点专项科研基金(20050422049)

摘　　要：目的:观察自体骨髓干细胞移植治疗下肢动脉缺血性疾病的临床疗效及影响因素。方法:28例下肢动脉缺血患者,均抽取自体骨髓血,体外提取单个核细胞,行缺血下肢局部肌肉注射,术后观察各项指标综合评估。将患者分为高浓度注射组和低浓度注射组,比较两组移植前后缺血改善情况。结果:28例患者总的疼痛缓解率及麻木感和冷感缓解率均为100%,5例溃疡出现愈合迹象,移植后临床评分(10.96±2.09)低于移植前(14.25±2.41),P<0.05;高浓度注射组注射前后评分差值(3.92±1.16)大于低浓度注射组(2.81±1.52,P<0.05。除1例于术后3个月出现浅静脉曲张外,未发现明显并发症。结论:自体骨髓干细胞移植治疗下肢动脉缺血性疾病是一种安全、有效的手段。干细胞提取的数量、动脉缺血的范围,尤其是干细胞注射浓度对于其治疗效果有重要影响。Objective：To observe the clinical efficacy and analyze the influcing factors of autologous transplantation of bone marrow mononuclear cells in the treatment of lower extremity ischemic disorders. Methods：Totally 28 cases were treated by autologous transplantation of bone marrow mononuclear cells. After aspiration of bone marrow blood from the iliums,the mononuclear cells were separated and then injected into the skeletal muscles of the ischemic legs. The clinical and laboratory findings were monitored after the surgery. Then the cases were divided into two groups by the concentration of the bone marrow mononuclear cells injected into the muscles. The improvement degrees of the two groups were compared. Results： The low limb pain alleviating rate was 100% as well as the skin turning warm and the insensible feeling alleviating rate, there was the sign of ulcer healing in 5 case. The clinical score after the transplantation （10.96±2.09） was lower than that before the transplantation （14.25±2.41）,P 〈0.05. The difference value of the group treated with higher mononuclear cells before and after the plantation is significantly higher than that of the group with lower mononuclear cells. No complications was found except 1 case appeared superficial varicosis. Conclusion： Autologous transplantation of bone marrow mononuclear cells could be a safe and effective method for treating patients with lower extremity ischemic disorder. The quantity of the mononuclear cells, the extent of ischemia, especially the concentration of the mononuclear cells injected into the muscles significantly influent the result of the treatment.

关 键 词：骨髓祖代细胞 移植 自体 腿 缺血 

分 类 号：R658.3[医药卫生—外科学] R457.7[医药卫生—临床医学]