干细胞移植治疗糖尿病足  

Stem cell transplantation for the treatment of diabetic foot

作　　者：王广宇[1] 朱旅云[1] 马利成[1] 胡丽叶[1] 李晓玲[1] 杨少玲[1] 单巍[1] 厚荣荣[1] 

机构地区：[1]白求恩国际和平医院内分泌科,河北省石家庄市050082

出　　处：《中国组织工程研究》2013年第1期173-180,共8页Chinese Journal of Tissue Engineering Research

摘　　要：背景:以自体骨髓、脐血单个核细胞移植治疗糖尿病足,对缺血性病变及周围神经损伤所致临床症状有改善作用,对糖尿病足也有较好的疗效。脐带间充质干细胞与骨髓干细胞和脐血干细胞相比有其自身的优势。目的:观察脐带间充质干细胞移植治疗糖尿病足病缺血及神经损伤的疗效。方法:选取2010至2012年住院行脐带间充质干细胞移植治疗的糖尿病足病患者32例,将脐带间充质干细胞稀释后行双下肢肌肉内注射,每个注射点间隔约3cm,每个肢体移植(5.02±1.37)×108个。于3个月和6个月后评价其下肢缺血和下肢周围神经病变情况。并检索CNKI数据库,对国内干细胞移植治疗糖尿病足的研究状况进行分析。结果与结论:移植后踝肱指数升降不一,移植后6个月疼痛评分及冷感评分明显改善,间歇性跛行及皮肤温度、经皮氧分压治疗后3,6个月与移植前比较差异均有显著性意义;对神经病变损伤自觉症状评分、临床检查评分、振动感觉阀值移植后6个月与移植前比较差异有显著性意义。腓浅神经、胫神经感觉神经传导速度,腓总神经、胫神经运动神经传导速度,在移植后3个月与移植前比较,差异无显著性意义(P>0.05),移植6个月与移植前相比较有升高,差异有显著性意义(P<0.05)。可见脐带间充质干细胞可以改善糖尿病缺血性病变及周围神经病变的临床症状及客观指标。文献分析结果发现,已有的研究中治疗结果都比较理想,多数研究中的移植方法为进行肌肉注射。BACKGROUND： Autologous bone marrow and umbilical blood mononuclear cell transplantation can improve the clinical symptoms caused by ischemic lesions and peripheral nerve injury, and have good effect on diabetic foot. Umbilical cord-derived mesenchymal stem cells have their own advantages when compared with bone marrow stem cells and umbilical cord blood stem cells.OBJECTIVE： To observe the effect of umbilical cord-derived mesenchymal stem cells on diabetic foot ischemic lesions and peripheral nerve injury. METHODS： Thirty-two patients with diabetic foot who received umbilical cord-derived mesenchymal stem cell transplantation from 2010 to 2012 were selected. Umbilical cord-derived mesenchymal stem cells were intramuscularly injected into the bilateral lower extremities with 3 cm distance between two injection sites after dilution. The number of implanted cells was （5.02±1.37） ×10^8 per leg. The lower extremity ischemia and lower extremity peripheral neuropathy were evaluated at 3 and 6 months after injection. The CMKI database was searched for the literatures in order to analyze the research situation of stem cell transplantation for the treatment of diabetic foot in China. RESULTS AND CONCLUSION： There was no significant difference in ankle/brachial index after treatment. The pain score and the apathetic score were significantly improved at 6 months after transplantation. There were significant differences in angina cruris, skin temperature and transcutaneous oxygen partial pressure after 3 or 6 months of treatment. After treatment for 6 months, there were significant differences in rational symptom score, clinical examination score and vibration perception threshold. There were no significant differences in the conduction velocity of motor/sensory nerves of peroneal nerve and tibial nerve at 3 months after transplantation when compared with those before transplantation （P 〉 0.05）, and there were significant differences at 6 months after transplantation when compared with those before tran

关 键 词：干细胞 干细胞临床实践 脐带间充质干细胞 骨髓干细胞 脐血干细胞 细胞移植 踝肱指数 神经传导速度 糖尿病足 缺血性病变 神经病变 

分 类 号：R394.2[医药卫生—医学遗传学]