自体骨髓干细胞移植治疗糖尿病足溃烂创面效果观察  

Effect of autologous bone marrow stem cell transplantation on ulcerated diabetic foot

作　　者：刘鹏[1] 刘延云 张晖[1] 朱超霞 张颖裕 LIU Peng;LIU Yan-yun;ZHANG Hui;ZHU Chao-xia;ZHANG Ying-yu(Department of Endocrinology,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang,Henan 471000,China;Department of Laboratory Medicine,the First Affiliated Hospital of Henan University of Science and Techunology,Luoyang,Henan 471000,China)

机构地区：[1]河南科技大学第一附属医院内分泌科,河南洛阳471000 [2]河南科技大学第一附属医院检验科,河南洛阳471000

出　　处：《中华实用诊断与治疗杂志》2021年第9期916-919,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20190550)。

摘　　要：目的探讨自体骨髓干细胞移植治疗糖尿病足溃烂创面的效果和安全性及对患肢神经传导速度的影响。方法 105例糖尿病足患者,51例(57足)采用常规内科综合治疗者为对照组,54例(62足)在常规内科综合治疗基础上给予自体骨髓干细胞移植治疗者为观察组。比较治疗前及治疗1、2个月时2组溃烂创面面积;比较治疗前及治疗2个月时2组间歇性跛行、患肢疼痛、患肢冷感评分及患肢胫神经、腓浅神经、腓总神经传导速度;记录观察组骨髓干细胞移植术中患肢疼痛、肿胀等发生情况;记录2组治疗7 d内肝、肾及凝血功能等指标异常情况;出院后随访6个月,记录2组患肢疼痛、肿胀及血管瘤发生情况。结果观察组治疗前溃烂创面面积[(15.03±2.41)cm^(2)]与对照组[(14.98±2.53)cm^(2)]比较差异无统计学意义(P>0.05);观察组治疗1、2个月时溃烂创面面积[(3.06±0.45)、(0.12±0.03)cm^(2)]均小于观察组[(6.33±0.75)、(2.90±0.45)cm^(2)](P<0.05);2组治疗1、2个月时溃烂创面面积均小于治疗前(P<0.05),治疗2个月时均小于治疗1个月时(P<0.05)。观察组治疗前间歇性跛行[(2.96±0.43)分]、患肢疼痛[(2.74±0.32)分]、患肢冷感[(3.03±0.51)分]评分与对照组[(3.01±0.51)、(2.86±0.50)、(2.98±0.48)分]比较差异均无统计学意义(P>0.05),治疗2个月时间歇性跛行[(0.90±0.15)分]、患肢疼痛[(0.86±0.21)分]、患肢冷感[(0.76±0.10)分]评分均低于对照组[(1.71±0.28、1.53±0.34、1.49±0.25)分](P<0.05);2组治疗2个月时间歇性跛行、患肢疼痛、患肢冷感评分均低于治疗前(P<0.05)。观察组治疗前患肢胫神经[(34.29±5.68)m/s]、腓浅神经[(37.41±4.52)m/s]、腓总神经[(36.45±5.20)m/s]传导速度与对照组[(34.32±5.70)、(37.53±4.60)、(36.71±5.97)m/s)]比较差异均无统计学意义(P>0.05),治疗2个月时患肢胫神经[(42.36±6.90)m/s]、腓浅神经[(46.98±5.17)m/s]、腓总神经[(44.36±5.72)m/s]传导速度均快于对Objective To investigate the effect and safety of autologous bone marrow stem cell transplantation in the treatment of diabetic foot ulcer ated wounds and its influence on nerve conduction velocity. Methods In 105 patients with diabetic foot syndrome, 51 patients(57 feet) received routine medical comprehensive treatment(control group), besides which the other 54 patients(62 feet) received autologous bone marrow stem cell transplantation(observation group). The area of ulcerated wounds was compared before treatment, as well as at 1 and 2 months after treatment between two groups. The scores of intermittent claudication, pain and cold sensation in the affected limb, as well as the conduction velocities of tibial nerve, superficial peroneal nerve and common peroneal nerve of the affected limb were compared before and at 2 months after treatment between two groups. The pain and swelling were recorded during autologous bone marrow stem cell transplantation in observation group. The nerve conduction velocities of the affected limb were compared before and after treatment between two groups. The occurrences of adverse reactions were compared between two groups. The hepatic and renal function, as well as the coagulation function were observed in 7 days after treatment. All patients were followed up for 6 months to record the occurrences of pain, swelling and hemangioma of the affected limb. Results There was no significant difference in the area of ulcerated wounds in observation group((15.03±2.41)cm^(2))and control group((14.98±2.53)cm^(2))before treatment(P>0.05).The ulcerated wound areas were smaller at 1 and 2 months after treatment in observation group((3.06±0.45),(0.12±0.03)cm^(2))than those in control group((6.33±0.75),(2.90±0.45)cm^(2))(P<0.05),smaller at 1 and 2 months after treatment than those before treatment in both groups(P<0.05),and smaller at 2 months after treatment than those at 1 month after treatment(P<0.05).The scores of intermittent claudication,pain and cold sensation in the affected limb sho

关 键 词：糖尿病足 自体骨髓干细胞移植 溃烂创面 神经传导速度 

分 类 号：R587.2[医药卫生—内分泌]