自体外周血单个核细胞移植术治疗难治性重度肢体缺血性疾病的疗效预测性研究  

Predictive research of therapeutic effect of autologous peripheral blood mononuclear cells transplantation in patients with no-option critical limb ischemia

作　　者：邵华[1] 孙英伦 李斌[1] 霍楠楠 辛明霞[1] 王寒 Shao Hua;Sun Yinglun;Li Bin;Huo Nannan;Xin Mingxia;Wang Han(Department of Vascular Surgery,Dalian University Affiliated Xinhua Hospital,Dalian 116021,China)

机构地区：[1]大连大学附属新华医院血管外科,大连116021

出　　处：《河南外科学杂志》2022年第2期18-21,共4页Henan Journal of Surgery

基　　金：大连市医学科学研究计划项目(1911118)。

摘　　要：目的探讨自体外周血单个核细胞(PBMNCs)移植术治疗难治性重度肢体缺血性疾病(NO-CLI)。通过确立无应答患者的独立危险因素进行疗效评估,以期为自体PBMNCs移植治疗NO-CLI患者的疗效预测提供重要依据。方法回顾性分析大连大学附属新华医院40例自体PBMNCs移植治疗NO-CLI患者的信息,统计患者的基线数据、移植物信息和术后6个月的治疗效果,最后进行Logistic回归分析。结果通过筛选后36例符合入组标准,其中30例NO-CLI患者行自体PBMNCs移植治疗效果良好,6例术后效果不佳最终行截肢手术。通过单因素回归分析得出吸烟、复吸烟、性别、肢体坏疽或感染、动脉闭塞平面、踝肱指数(ABI)、经皮氧分压(TcPO_(2))、炎症反应、糖尿病均是影响自体PBMNCs移植术治疗NO-CLI疗效的因素(P<0.05)。通过多因素回归分析结果提示TcPO_(2)是影响自体PBMNCs移植术治疗NO-CLI疗效的独立因素(P<0.05)。结论影响自体PBMNCs移植术治疗NO-CLI疗效的因素较多。其中对自体PBMNCs移植术治疗NO-CLI疗效的预测性评判采用TcPO_(2)指标具有较高的应用价值。Objective To Investigate the efficiency of autologous peripheral blood mononuclear cells(PBMNCs)transplantation in patients with no-option critical limb ischemia(NO-CLI)by confirming the independent risk factors of unresponsive patients,which is expected to provide important evidence for the prediction of effect of patients with NO-CLI who have accepted PBMNCs transplantation.Methods A retrospective analysis of 40 patients with NO-CLI in Xinhua Hospital affiliated to Dalian University.Collect the baseline data,graft information and therapeutic effect after 6 months of these patients and finally make Logistic regression analysis.Results After filtering,36 NO-CLI patients met the criteria.30 NO-CLI patients of them after PBMNCs transplantation have good treatment effect,while the other 6 NO-CLI patients after PBMNCs transplantation have poor treatment effect and finally lead to amputation.By using single factor regression analysis,the risk factors that influence therapeutic effect after PBMNCs transplantation are concluded,including smoking,after smoking,gender,gangrene or infection,vascular occlusion,ankle/brachial index(ABI),transcutaneous pressure of oxygen,(TcPO_(2)),inflammatory response and diabetes mellitus.(P<0.05)By using multiple factor regression analysis,the independent risk factor that influence therapeutic effect after PBMNCs transplantation is TcPO_(2).(P<0.05).Conclusion Many factors can influence the treatment effect of PBMNCs transplantation in patients with NO-CLI.TcPO_(2) is of high application value as the predictive evaluation index of PBMNCs transplantation in patients with NO-CLI.

关 键 词：外周血单个核细胞 难治性重度肢体缺血 自体移植 疗效预测。 

分 类 号：R654.4[医药卫生—外科学]