自体外周血单核细胞移植治疗重度下肢缺血的临床疗效  

Clinical analysis of autologous peripheral blood mononuclear cells for treating critical limb ischemia

作　　者：方征东[1] 王晓天[1] 胡何节[1] 孙小杰[1] 葛新宝[1] 程灿[1] 

机构地区：[1]安徽医科大学附属省立医院血管外科,合肥230001

出　　处：《中国临床保健杂志》2017年第4期345-348,共4页Chinese Journal of Clinical Healthcare

基　　金：安徽省自然科学基金(1408085MH177);安徽省公益性技术应用研究联动计划(1704f0804013)

摘　　要：目的探讨自体外周血单核细胞治疗重度下肢缺血的长期疗效和安全性。方法回顾性分析行自体外周血单核细胞治疗的重度下肢缺血患者的临床资料。根据引起下肢缺血的原因,患者分为2组:动脉硬化闭塞(ASO)组,共29例;血栓闭塞性脉管炎(TAO)组,共43例。采用临床症状及下肢血流改变进行疗效评价,随访所有患者治疗后3年内疗效及不良反应情况。结果 ASO组患者临床症状评分和血流灌注参数在6个月内明显改善,但随着随访时间延长又逐渐恶化至术前水平;TAO组患者临床症状评分和血流灌注参数在改善后能得到长时间维持(P<0.05)。随访结束,ASO组免截肢率为17.2%,TAO组免截肢率为65.1%(F=15.99,P<0.05)。结论自体外周血单核细胞移植是治疗重度下肢缺血安全、有效的方法,适合于血栓闭塞性脉管炎引起的重度下肢缺血。Objective To evaluate long-term clinical outcomes after autologous peripheral blood mononuclear ceils（PBMNC） implantation in patients with critical limb ischemia（CLI）. Methods The clinical data of 72 patients with CLI were analyzed retrospectively. There were 29 patients with arteriosclerosis（ASO） and 43 patients with thrombo- angiitis obliterans（TAO）. A series of clinical outcomes and laboratory findings were compared between the ASO and TAO group. Results In patients with ASO, clinical symptoms, ankle brachial pressure index （ABI） and transcutaneous oxygen pressure （ TcpO2 ） improved after 1 month, but gradually decreased during 3-year follow-up and returned to base- line levels. In TAO group, clinical symptoms, ABI and TcpO2 were significantly increased after 1 month and remained high during 3-year follow-up. The amputation-free rates after PBMNC implantation were 17.2% in ASO group and 61.5% in TAO group. Conclusions PBMNC implantation is safe and effective in patients with CLI. Compared with ASO, PBMNC implantation is more effective in CLI patients with TAO disease.

关 键 词：闭塞性动脉硬化 闭塞性血栓性脉管炎 下肢 细胞移植 单核细胞 

分 类 号：R654.4[医药卫生—外科学]