血管腔内成形术联合自体外周血干细胞注射治疗下肢缺血性疾病

Percutaneous transluminal angioplasty combined with autologous peripheral blood stem cells for lower extremity ischemia

目的研究血管腔内成形术（percutaneous transluminal angioplasty，PTA）联合自体外周血干细胞（peripheral blood stem cells，PBSC）注射治疗下肢缺血性疾病的临床疗效。方法回顾性分析2006年3月至2008年6月收治的的82例患下肢缺血性疾病患者的临床资料，治疗组42例下肢缺血陛疾病患者行PTA术联合自体PBSC注射治疗，对照组40例患者行单纯PTA术，比较两种方法之疗效。结果所有患者顺利接受治疗。治疗组ABI由术前0．32±0．11提高至术后第3个月的0．50±0．14和术后第6个月的0．49±0．13（t=-6．765和-6．040，P〈0．05），TcPO2由术前（26．1±2．3）mmHg提高至术后第3个月的（32．7±4．2）mmHg和术后第6个月的（34．5±2．7）mmHg（t=-8．901和-14．250，P〈0．05），对照组ABI由术前0．30±0．12提高至术后的0．47±0．15及0．47±0．13（t=-5．631和-5．873，P〈0．05），TePO2由术前（25．9±2．4）mmHg提高至术后第3个月的（28．9±2．9）mmHg及术后第6个月的（28．9±2．1）mmHg（t=-5．090和-5．389，P〈0．05）。治疗组术后TcPO2高于对照组（P〈0．05）。结论PTA和自体PBSC注射是治疗缺血性下肢血管病有效的手段，自体PBSC注射有持续性升高TcPO2的作用，两者的联合运用效果优于单纯PTA术。

Objective To observe the clinical effect of percutaneous transluminal angioplasty （PTA） combined with autologous peripheral blood stem cells （PBSC） transplantation in the treatment of lower extremity iscbemic disorders. Methods Fourty-two cases of lower extremity ischemic disorders in the treatment group were treated with PTA and autologous peripheral blood stem cells injection and 40 cases in control group were treated with PTA exclusively. Results All the procedures were successful. In treatment group, ABI improved from 0. 32 ±0. 11 to （at the 3^rd month）and 0. 49 ±0. 13（at the 6^th month） （t= -6.765, -6.040, P 〈0.05） while TcPO2 improved from （26.1 ±2.3） mm Hg to （32.7 ± 4.2） mm Hg（ at the 3ra month） and （34. 5 ± 2.7） mm Hg （ at the 6^th month） （ t = - 8.901, - 14. 250, P 〈 0. 05 ）. In control group, ABI improved from 0.30 ± 0. 12 to 0.47 ± 0. 15 and 0.47 ±0. 13 （ t = - 5. 631, - 5. 873, P 〈 0. 05 ） while TcPO2 increased from （ 25.9 ±2. 4 ） mm Hg to （ 28.9 ± 2. 9 ） mm Hg （ at the 3^rd month）and （28.9 ±2.1） mm Hg（at the 6^th month） （t = -5.090, -5.389,P〈0.05）. There was significant difference in TcPO2 on follow-up between the two groups after the treatment （ P 〈 0. 05 ）. Conclusion Autologous PBSC transplantation in combination of PTA was effective for the treatment of lower extremity ischemic disorders. PBSC injection helps to increase TcPO2.