自体外周血干细胞移植在下肢缺血性疾病中的应用

Evaluation of Peripheral Blood Stem Cells Transplantation in Treatment of Lower Extrenmity Ischemia

目的观察自体外周血干细胞移植治疗下肢缺血性疾病的效果。方法16例患者均给予G-CSF300μg/d,进行3d动员,第4天用CS-3000plus血细胞分离机采集患者自体单个核细胞,处理全血量(6554±563)ml,抗凝剂(ACD)(661±62)ml,将采集的干细胞悬液注射于双/单侧下肢小腿腓肠肌,每侧注射40个点位,0.75ml/点,每点干细胞数>1×108,间距30mm,深15mm。结果采集物中白细胞(1.71±0.77)×108/ml,单个核细胞百分率(96.3±2.6)%,CD34+细胞(1.68±0.81)×106/ml,产品容积(58.9±1.8)ml,14例患者外周血干细胞移植后疼痛、间歇性跛行、患肢发凉、皮色灰暗、溃疡等临床症状明显改善,2例临床症状未改善,有效率87.5%。结论自体外周血干细胞移植对患者损伤小、操作方便,适用于对药物治疗无效且不适于手术治疗的患者。

A total of 16 patients with ischemic lower extremity received G-CSF 300 μg/d by hypodermic injection for 3 days to moblize stem ceils. On the third day, PBSC were collected by CS-3000plus blood cell separator. The total volum of blood processed was （6 554±563）ml and the volum of anticoagulant（ACD） was （661±62）mlo Then the collected PBSC were injected into the gastrocnemius of ischemic lower limbs,and 40 points on each side,0. 75 ml per point. The number of PBSC was more than 1 × 10^8 in each point. The distance between each point was 30mm, and the depth of each point was 15 mm. Results The number of monouclear cells（MNC） in the product was （1.71±0. 77）× 10^8/ml, monouclear cells account for （96.3±2.6）%, and the number of CD34^＋ cells was （1.68±0. 81）× 10^6/ml, the volum of the product was （58. 9±1.8） ml. In 16 patients with PBSC transplantation,the symptoms, such as pain, angina, cruris, local cool-feeling, skin gloomy, ulcer in 14 cases were improved. But symptoms in 2 cases were not improved . The rate of effectiveness was 87. 5%. Conclusion Auotologous PBSC transplantation might be a simple,safe and effective method for treatment of ischemic lower extremity.