人脐带间充质干细胞移植治疗动脉硬化闭塞症合并严重肢体缺血一例报道并文献复习  

Human Umbilical Cord Mesenchymal Stem Cell Therapy for Patient With Critical Limb Ischemia Due to Atherosclerosis Obliterans:One Case Report and Literature Review

作　　者：李星儿[1] 陈建平[1] 秦曦[1] 郭媛媛[1] 詹瑶璇[1] 黄晓珊[1] 

机构地区：[1]广州医科大学附属第五医院康复医学科,广东省广州市510700

出　　处：《中国全科医学》2016年第17期2106-2110,共5页Chinese General Practice

摘　　要：目的探讨人脐带间充质干细胞(h UC-MSCs)移植治疗动脉硬化闭塞症(ASO)合并严重肢体缺血(CLI)的疗效与可行性。方法 2015-04-03,广州医科大学附属第五医院采用h UC-MSCs移植治疗1例下肢ASO合并CLI拟截肢患者,现报道其诊疗过程和结局,并复习相关文献。结果患者h UC-MSCs移植治疗前患肢褥疮和拇趾坏疽久治不愈,疼痛剧烈,褥疮破溃出现窦道,表面及周围见脓性分泌物,面临截肢。行h UC-MSCs移植治疗3次后,窦道表面闭合,结痂,脓性分泌物消失,创口干燥。治疗后6个月,窦道内部完全闭合,坏死组织脱落,创面完全愈合,患者避免截肢,临床痊愈。结论 ASO合并CLI拟截肢患者可通过行h UC-MSCs移植治疗改善下肢缺血状态,实现病情逆转,h UC-MSCs有望成为骨髓间充质干细胞和脐血干细胞治疗ASO的替代品,值得进行进一步的临床试验和机制研究。Objective To investigate the curative effect and feasibility of human umbilical cord mesenchymal stem cell （hUC-MSCs） therapy for patients with critical limb ischemia （CLI） due to atherosclerosis obliterans （ASO）. Methods The treatment process and outcome of a patient with CLI due to ASO who planed to receive amputation but accepted the hUC-MSCs therapy in the Fifth Affiliated Hospital of Guangzhou Medical University in 2015 -04 -03 were reported, and related literature was reviewed. Results Before hUC-MSCs therapy, the patient suffered from severe pain due to the bedsore in the limbs and the gangrene of the hallux toe. There were sinus tracts under the bedsore which were surrounded by a lot of purulent secretions. Then the patient planed to receive amputation. However, after three times of hUC-MSCs therapy, the surface of sinus tracts closed, purulent secretions disappeared, and the wounds scabbed and dried; six months after hUC-MSCs therapy, the inner parts of the sinus tracts closed, necrotic tissues fell off, and the wound shealed. The patient was able to avoid amputation and had clinical recovery. Conclusion hUC-MSCs therapy may improve the ischemic condition of patients with CLI due to ASO who plan to have amputation and even reverse the disease condition, hUC-MSCs may be a potential alternative for bone marrow derived mesenchymal stem cells and umbilical cord blood derived stem cells in the treatment of ASO. However, further clinical trials and mechanism research are needed.

关 键 词：间质干细胞移植 闭塞性动脉硬化 严重肢体缺血 坏疽 截肢 

分 类 号：R617[医药卫生—外科学] R543.5[医药卫生—临床医学]