自体骨髓干细胞移植联合长球囊血管成形术治疗糖尿病足下肢血管病变  

Autologous bone marrow stem cell transplantation combined with long balloon angioplasty improve lower extremity ischaemia in patients with diabetic foot

作　　者：孙铭良[1] 王默[2] 王敏 陈青[3] 张十一[2] 李秋[3] 

机构地区：[1]山东中医药大学,济南250000 [2] 山东大学附属省立医院血管外科 [3] 山东大学附属省立医院内分泌科 [4]泰安市人民医院内科

出　　处：《中华糖尿病杂志》2016年第7期396-400,共5页CHINESE JOURNAL OF DIABETES MELLITUS

基　　金：国家科技重大专项（2015zx09101019）;山东省科技发展计划项目（2010GSF10261）

摘　　要：目的回顾性分析自体骨髓干细胞移植联合长球囊血管成形术治疗糖尿病足下肢血管病变的临床疗效。方法入选2008年7月至2013年8月收入山东省立医院内分泌科及血管外科的符合标准的糖尿病足患者40例，其中自体骨髓干细胞移植联合长球囊血管成形术治疗组20例，单纯长球囊血管成形术治疗组（对照组）20例，比较2组患者足部皮肤温度、动脉搏动、踝肱指数（ABI）、行走距离、经皮氧分压等指标的改变。两组资料样本量的比较采用两样本t检验，术前术后不同时间点比较采用方差分析，2组率的比较采用χ2检验。结果（1）2组患者治疗前后皮肤温度、静息痛、足部动脉搏动均有明显改善（χ2=5.855、5.132、4.710，均P〈0.05）。（2）2组患者治疗前后踝肱指数、行走距离、经皮氧分压等客观指标均有明显改善（t=2.585、23.643、2.302，均P〈0.05）。（3）对照组血管再狭窄或闭塞7例，再狭窄率为46.15%（12/26）；治疗组血管再狭窄或闭塞4例，再狭窄率16.67%（4/24），两组血管的再狭窄率比较有统计学差异（χ2=4.987，P〈0.05）。结论自体骨髓干细胞移植联合长球囊血管成形术治疗糖尿病足下肢血管病变可以明显改善患者的临床症状，降低血管再狭窄率，提高临床治疗效果。Objective To assess the effect of autologous bone marrow stem cell transplantation combined with long balloon angioplasty in treatment of diabetic foot lower extremity vascular disease. Methods Forty cases of diabetic foot patients admitted in the Department of Endocrinology and Vascular Surgery of Shandong Provential Hospital from July 2008 to August 2013 were recruited. Patients were randomly divided into autologous bone marrow stem cell transplantation combined with long balloon angioplasty treatment group （combined treatment group, n=20） and long balloon angioplasty therapy only group （control group, n=20）.Foot skin temperature, arterial pulse, ankle brachial index （ABI） and other markers were compared. Two sample t test was used for continuous data. Before and after surgery comparison with different time points were analyzed using analysis of variance. Categorical data was compared byχ2 test. Results （1） Skin temperature, rest pain and other subjective indicators had improved significantly（χ2=4.710-5.855,P〈0.05） in the 2 groups after treatment. （2）The ankle brachial index, walking distance, skin oxygen partial pressure and other objective indicators were significantly improved（t=2.302-23.643,P〈0.05） in the 2 groups after treatment. （3）In the control group, 7 cases were restenosis or occlusion, the restenosis rate was 46.15%（12/26）. In the treatment group, 4 cases developed restenosis or occlusion, the restenosis rate was 16.67%（4/24）. The restenosis rate of the two groups was statistically significant （χ2=4.987, P〈0.05）. Conclusion Autologous bone marrow stem cell transplantation combined with prolate spheroidal balloon angioplasty surgery can significantly improve the clinical symptoms of ischaemia in＆amp;nbsp;patients with diabetic foot, combined treatment shows greater reduction in the rate of restenosis and overall improvement of clinical therapeutic effect.

关 键 词：糖尿病足 自体骨髓干细胞移植 长球囊血管成形术 

分 类 号：R587.2[医药卫生—内分泌]