自体骨髓祖细胞移植对下肢动脉缺血导致创面中VE-钙黏附分子的影响  

The influence of autologons bone marrow stem cell transplantation on the vascular endothelial cadherin in patients with lower limb ischemic wounds

作　　者：王晓军[1] 宋国成[1] 王建宁[1] 张军[1] 高继东[1] 殷岳[1] 

机构地区：[1]北京市第六医院血管外科,100083

出　　处：《中华损伤与修复杂志（电子版）》2007年第2期85-89,共5页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

摘　　要：目的检测自体骨髓祖细胞移植前后下肢创面中VE-钙黏附分子的变化特性,对自体骨髓祖细胞移植治疗下肢动脉缺血导致创面进行机理探讨,为临床的治疗提供依据。方法2003年6月至2006年8月对199例下肢动脉缺血导致创面的患者采用超声彩色多普勒和选择性血管造影进行检查是否存在下肢动脉的缺血,97例患者行自体骨髓祖细胞移植治疗,应用RT-PCR、Western blot和免疫荧光染色等技术检测检测移植前和后1周、2周、1月、2月和3月下肢创面中VE-钙黏附分子mRNA和蛋白质的变化。结果(1)超声彩色多普勒检查结果:阳性结果173例(阳性率87%,173/199),其中完全闭塞者40例(23%,40/173),重度狭窄者64例(37%,64/173),中度狭窄者69例(40%,69/173);(2)199例患者中行选择性血管造影者169例,阳性结果为128例(76%,128/169),其中髂总动脉+髂外动脉+股动脉闭塞或狭窄者15例(12%,15/128),髂外动脉+股动脉闭塞或狭窄者31例(24%,31/128),股动脉+腘动脉闭塞或狭窄者45例(35%,45/128),腘动脉下动脉血管闭塞或狭窄者37例(29%,37/128);(3)199例患者中,应用自体骨髓祖细胞移植的患者97例(48%,97/199),和同程度未行自体骨髓祖细胞移植的患者比较创面愈合时间平均缩短28±3天(P<0.05);(4)自体骨髓祖细胞移植后1周到1月VE-钙黏附分子的mRNA和蛋白质表达呈缓慢增长趋势,移植后2月到3月为明显表达增加趋势。结论自体骨髓祖细胞的移植可以促进下肢动脉缺血导致溃疡创面的愈合,VE-钙黏附分子的表达在新生的血管形成和侧枝循环的形成中起关键的作用。Objective The changes in vascular endothelial cadherin in the lower limb ischemic wounds of patients receiving autologous bone marrow stem cell transplantion were examined. Methods From June 2003 to August 2006, 199 patients suffering from wounds with lower limb ischemia were analyzed and evaluated by color ultrasonic Doppler and selective blood vessel contrast examination. The patients with lower limb ischemia were examined by digital subtraction angiographic （DSA） and colour Doppler to check the existence of lower limb arterial ischemia. Ninety-seven patients with lower limb ischemia were treated by autologous bone marrow stem cell transplantion. The changes of vascular endothelial cadherin in wound of patients with lower limb ischemia by autologous bone marrow stem cell transplantion was examined by RT-PCR, Western blot and immunofluorescence before and 1 week, 2 weeks, 1 month, 2 months and 3 months after the transplantation. Results （1）The colour Doppler were performed in 199 patients with lower limb ischemia, the positive rate was 87% （173/199）. Among them, the narrow rate of total, severe and medium straitness was 23% （40/173）, 37% （64/173） and 40% （69/173, respectively）. （2） The DSA was performed in 169 patients with lower limb isehemia,the positive rate was 76% （128/169）. Among them, the narrow rate of common iliac a. ＋ Ext. iliac a. ＋ femoral a. , Ext. iliac a. ＋ femoral a. , femoral a. ＋ popliteal a. and lower of popliteal a. was 12% （15/128） ,24% （31/128） ,35% （45/128） and 29% （37/128）, respectively. （3）The autologous bone marrow stem cell transplantation was performed in 48% （97/199） patients with lower limb ischemia. The wound healing in patient with lower limb ischemia receiving autologous bone marrow stem cell transplantation was 28 ± 3 days （ P 〈 0.05 ） shorter than that without the stem cell transplantation. （4）The expression of mRNA and protein of vascular endothelial cadherin in wound of patients with lower limb ischemi

关 键 词：下肢动脉缺血 骨髓祖细胞 移植 血管内皮(VE)-钙黏附分子 

分 类 号：R654.3[医药卫生—外科学]