自体外周血干细胞移植治疗糖尿病足26例临床研究

Transplantation of autologous peripheral blood stem cells for the treatment of diabetic foot in 26 cases

目的 观察自体外周血干细胞移植治疗糖尿病足的临床疗效及相关影响因素。方法 自 2 0 0 3- 112 0 0 4 - 0 7解放军第 4 6 3医院对 2 6例自愿接受自体外周血干细胞移植的糖尿病足患者进行外周血干细胞动员 ,给予rhG -CSF每天 4 5 0 6 0 0 μg ,皮下注射 ,第 6天用COBE 6 1血细胞分离机单采干细胞 ,总量 82 14 8mL。将干细胞悬液按 3cm×3cm距离进行缺血肢体移植术 ,移植后观察各项指标综合评估。结果 移植后 314d 2 3例患者疼痛明显缓解 ,2 7d2 4例患肢冷感有不同程度的改善 ,4 12周 4例溃疡明显好转 ,踝压指数 (ABI) 6例患者改善。 2例DSA下肢动脉造影结果显示新侧支血管形成明显增加。未出现并发症和不良反应。结论 自体外周血干细胞移植治疗糖尿病足是一种简便、安全。

Objective To observe the clinical efficacy of autologous peripheral blood stem cells (PBSC) transplantation in 26 cases of diabetic foot.Methods From 2003-11 to 2004-07,26 patients with diabetic foot received rhG-CSF 450~600ug/d by hypodermic injection for 5 days to mobilize stem cells.On the sixth day,PBSC were collected by COBE 6.1 Spectra Version for 82~148ml.The PBSC were injected into the ischemic lower limbs and foot intramuscularly for 3×3 cm distance.The clinical and laboratory findings were monitored.Results In 26 patients receiving PBSC transplantation,obvious pain-relief was shown in 23 cases for 3~14 days,foot cold-feeling changed in 24 patients after 2~7 days,foot ulcer improved in 4 cases after 4~12 weeks.ABI increased in 6 cases.Digital subtraction angiographic scores were peformed in 2 patients after 8 weeks,and there was new collateral vessels formation.No related complication or adverse effects were observed in all process.Conclusion Autologous PBSC transplantation might be a safe and effctive method for diabetic foot.