自体骨髓干细胞移植治疗肢体淋巴水肿27例  

Autologous bone marrow stem cell transplantation for extremity lymphedema in 27 cases

作　　者：吕晓霞[1] 尹至[2] 金星[1] 吴学君[1] 侯向前[1] 

机构地区：[1]山东大学附属省立医院,山东省济南市250021 [2]复旦大学附属中山医院,上海市200032

出　　处：《中国组织工程研究与临床康复》2008年第34期6653-6656,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景：骨髓干细胞具有高度增殖并分化为体内各种细胞的能力，移植后能够提供内皮细胞及细胞因子并促进毛细淋巴管生成。目的：评价自体骨髓干细胞移植治疗肢体淋巴水肿的临床疗效。设计、时间及地点：自身对照的前瞻性实验，于2004．10／2007—12在山东大学附属省立医院血管外科及科研中心完成。对象：淋巴水肿的患者27例，男7例，女20例，年龄21～53岁。方法：患者接受自体骨髓干细胞移植前采用肢体淋巴水肿的常规康复治疗。抽取患者自体骨髓后，用干细胞分离液处理并离心骨髓干细胞，制备干细胞悬液，对患者进行自体骨髓干细胞移植，将骨髓干细直接注射至患肢淋巴水肿区域处。主要观察指标：以患者治疗前和治疗后3个月健侧与患侧肢体特定截面周长的差值评价肢体淋巴水肿程度。结果：所有接受自体骨髓干细胞移植的患者，症状均有不同程度的改善，肢体肿胀明显消退，肢体沉重感减轻，瘢痕软化，上肢水肿患者术前健侧与患侧差值为（9．2±1．4）cm，治疗后3个月为（3．5±0．9）cm，下肢水肿患者术前健侧与患侧差值为（8．2±1．3）cm，治疗后3个月为（3．7±0．6）cm。结论：自体骨髓干细胞移植对肢体慢性淋巴水肿具有明显的治疗作用。BACKGROUND： Bone marrow stem cells have the potential to highly proliferate and differentiate into varied cells, and can provide endothelial cells and cytokines, and stimulate the formation of new lymphatic vessels. OBJECTIVE： To assess the clinical efficacy of autologous bone marrow stem cell transplantation in the treatment of extremity lymphedema. DESIGN, TIME AND SETTING： The self-consistency validation prospective study was performed at the Department of Vascular Surgery and Central Laboratory in Shandong Provincial Hospital Affiliated to Shandong University from October 2004 to December 2007. PARTICIPANTS： Totally 27 patients with lymphedema, including 7 males and 20 females, with the age ranged from 21 to 53 years old. METHODS： Patients were treated with autologous transplantation of bone marrow stem cells subsequent to routine rehabilitative treatment of limb lymphedema. Bone marrow stem cells were isolated from bone marrow by density gradient centrifugation to prepare stem cell suspension, and were intramuscularly injected into the suffered limbs. The range and position of puncture depend on the area of lymphedema. MAIN OUTCOME MEASURES： The severity of lymphedema was assessed by the difference of section perimeter of affected and unaffected sides before and 3 months after the treatment. RESULTS： Symptoms of all the patients undergoing bone marrow stem cell transplantation were alleviate to a certain extent. Edema and feeling of ponderosity were moderated evidently. Cicatricle was softened. The difference of affected and unaffected sides in upper limb dropsy patients was （9.2± 1.4） cm before treatment, and （3.5 ±0.9） cm after 3 months of treatment. The difference of affected and unaffected sides in lower limb dropsy patients was （8.2±1.3） cm before treatment, and （3.7±0.6） cm after 3 months of treatment. CONCLUSION： Bone marrow stem cell transplantation has evident effect on treating chronic extremity lymphedema.

关 键 词：骨髓干细胞 自体移植 淋巴水肿 淋巴管生成 

分 类 号：R394.2[医药卫生—医学遗传学]