彩色多普勒超声评价自体外周血干细胞移植治疗糖尿病下肢动脉闭塞症:与血管造影结果吻合吗?  

Evaluation of autologous peripheral blood stem cell transplantation for diabetes combined with lower limb artery obturation using color Doppler ultrasound:Identical to results from angiography?

作　　者：周方平[1] 常洪贤[1] 姚秀松[1] 陈晶[1] 张慧[1] 姜昆[1] 孙宏[1] 刘建[1] 隋阳[1] 

机构地区：[1]吉林医药学院附属医院电诊科,吉林省吉林市132013

出　　处：《中国组织工程研究与临床康复》2010年第14期2545-2548,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：吉林省科技厅科技发展资助项目(200705411)~~

摘　　要：背景:糖尿病下肢动脉闭塞的传统治疗方法如药物、介入等效果不佳,干细胞移植是近几年治疗该病变的新方法,临床取得了较好的效果。评价干细胞移植的治疗效果造影检查损伤大,费用高,所以采用彩色多普勒超声进行下肢动脉无创性检查具有重要的临床价值。目的:应用彩色多普勒超声评价自体外周血干细胞移植后下肢动脉病变的改善情况,并与血管造影结果相比较。方法:纳入确诊糖尿病下肢动脉闭塞症患者41例,经重组人粒细胞集落刺激因子150μg皮下注射,1次/d进行外周血干细胞动员,第5天用血细胞分离机采集分离干细胞,配成干细胞悬液,将干细胞悬液肌肉注射进行双下肢移植(3×109细胞/肢)。干细胞移植后观察3个月至1年,同时进行各项指标的综合评估。结果与结论:干细胞移植后,患肢疼痛、冷感、间歇性跛行、溃疡明显好转,踝臂指数明显升高(P<0.01),彩色多普勒超声测量足背动脉血流速度明显增加(P<0.01)。移植后下肢动脉管腔血流有不同程度改善,闭塞动脉周围、肌肉内的侧支血管增多;螺旋CT血管造影显示新生侧支血管明显增多。41例患者均未发生并发症和不良反应。提示彩色多普勒超声可准确、快速地检测和评价干细胞移植后下肢血运改善情况,和血管造影结果相吻合,在评价干细胞移植治疗糖尿病下肢动脉闭塞症的疗效方面能为临床提供可靠的诊断依据。BACKGROUND：Traditional therapeutic methods of diabetes combined with lower limb artery obturation showed poor outcomes such as drug or intervention.Stem cell transplantation is a new method to treat this disease in recent years,and has obtained good outcomes in the clinic.Evaluating the therapeutic outcomes of stem cell transplantation has great damage and cost much.Thus,color Doppler ultrasound is used to examine non-invasion in the artery of the lower extremity,which shows important clinical value.OBJECTIVE：To evaluate improvement of lower extremity artery lesion following autologous peripheral blood stem cell transplantation using color Doppler ultrasound,and to compare with results of angiography.METHODS：A total of 41 patients diagnosed as having diabetes combined with lower limb artery obturation were included.Following administration of recombinant human granulocyte-colony stimulating factor（rhG-CSF）（150 μg/d） for 5 days,peripheral blood mononuclear cells（PBMNCs） were mobilized and harvested by using a separator at day 5 to prepare stem cell suspension,and which were injected intramuscularly in the diseased extremities（3×109 per limb）.The clinical and laboratory findings were monitored every week for 3 months to 1 year following stem cell transplantation.RESULTS AND CONCLUSION：After stem cell transplantation,severe pain lameness,local cool-feeling and ulcer were significantly improved,and ankle-brachial index was increased obviously（P 〈0.01）.Color Doppler ultrasonography measurement showed that peak systolic velocity in diseased extremities was significantly increased post-transplantation（P 〈0.01）.Following transplantation,blood flow of the lower limb arterial canal was improved to different extents;collateral vessels were increased surrounding obstructed artery and in muscles.Spiral CT for new collateral vessel formation were showed increased.No related complication or adverse effects were observed in 41 patients during observation.Results indicated that color Doppler

关 键 词：彩色多普勒超声 糖尿病 造血干细胞 干细胞移植 下肢动脉闭塞症 

分 类 号：R394.2[医药卫生—医学遗传学]