自体骨髓干细胞移植治疗血栓闭塞性脉管炎效果观察  

Effectiveness Observation of Stem Cell Transplantation with Autologous Bone Marrow in Treatment of Thromboangiitis Obliterans

作　　者：王茂华[1] 孙岩[1] 吴学君[1] 金星[1] 张精勇[1] 

机构地区：[1]山东大学附属省立医院血管外科,济南250021

出　　处：《解放军医药杂志》2014年第3期104-106,共3页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：山东省自然科学基金(ZR2012HM063);高等学校博士学科点专项科研基金(20090131110059)

摘　　要：目的 观察自体骨髓干细胞移植治疗血栓闭塞性脉管炎的临床应用效果及安全性.方法 对2004年9月-2012年12月收治的9例血栓闭塞性脉管炎患者（9条患肢）于缺血肢体行自体骨髓干细胞肌内注射移植,移植治疗3个月后,采用视觉模拟评分（VAS）法评估患肢疼痛缓解情况,并观察间歇性跛行距离、踝肱指数（ABI）和足部溃疡愈合情况.结果 移植治疗3个月后疼痛缓解8例,9例VAS评分由术前（7.89＆#177;1.36）分降至（2.11＆#177;2.20）分,差异有统计学意义（P〈0.05）;与术前比较,间歇性跛行距离明显延长、ABI明显升高（P〈0.05）;2例足部溃疡1例痊愈,1例溃疡面积明显缩小.随访6～24个月,患者症状及ABI均无恶化,无不良反应发生.结论 自体骨髓干细胞移植治疗血栓闭塞性脉管炎安全性好,近、中期疗效确切.Objective To observe the clinical effect and safety of stem cell transplantation with autologous bone marrow in treatment of thromboangiitis obliterans. Methods Nine patients with thromboangiitis obliterans （ 9 affected limbs） admitted during September 2004 and December 2012 underwent transplantation of autologous myeloid stem cells into ischemic muscles. Three months after transplantation, indexes of pain relief were evaluated with visual analogue score （VAS）, and distance of intermittent claudication, ankle brachial index （ABI） and improvement of skin ulcer in feet were also observed. Results Three months after transplantation, 8 patients were relieved of pains, VAS score was improved from preoperative （7.89 ＋ 1.36） points to postoperative （2.11 ~ 2.20） points in9 cases, and the difference was statistically significant （P 〈 0.05 ） ; compared with those before transplantation, the distance of intermittent claudica- tion was significantly increased, and ABI was significantly higher after treatment （P 〈 0. 05） ; In the 2 cases of skin ul- cer, one was healed, and the other was obviously improved. During the follow-up for 6-24 months, the patients＇symptoms and ABI had no deterioration, and no adverse reaction was observed. Conclusion Stem cell transplantation with autolo- gous bone marrow in treatment of thromboangiitis obliterans is safe and has good clinical effect in the near and intermediate courses.

关 键 词：血栓闭塞性脉管炎 自体骨髓干细胞 移植 治疗结果 踝肱指数 

分 类 号：R457.7[医药卫生—治疗学]