自体骨髓干细胞移植治疗糖尿病足患者血管内皮生长因子的表达及意义

VEGF Expression in Diabetic Foot Patients Treated with Autologous Bone Marrow Stem Cell Transplantation and Its Significance

目的探讨自体骨髓干细胞移植治疗糖尿病足患者血管内皮生长因子(VEGF)的表达及其临床意义。方法选择经自体骨髓干细胞移植治疗的糖尿病足患者30例,在术前以及术后2、4、8、12周分别抽取静脉血,用ELISA法检测血清VEGF水平,同时分别取患处及周围组织,用RT-PCR法检测VEGFmRNA表达水平。另外,选择30例健康体检者作为对照组,进行血清VEGF和组织VEGFmRNA检测。结果糖尿病足患者血清VEGF水平显著高于对照组,而组织VEGFmRNA水平则显著低于对照组,差异有统计学意义(P<0.01)。糖尿病足患者术后2周血清VEGF水平到达最高,随后逐渐下降,到12周又恢复到术前水平(P>0.05);术后4周组织VEGFmRNA水平到达最高,随后逐渐下降,到术后8周时与术前无显著差异,术后12周时与对照组比较差异无统计学意义(P>0.05)。结论自体骨髓干细胞移植治疗后前4周是糖尿病足损伤组织毛细血管生成、表皮再生和修复的最旺盛阶段,4周以后随着部分组织的修复,VEGFmRNA水平逐渐下降。故术后4周后对患者未完全恢复的组织再次进行干细胞移植治疗将起到更好的效果。可见,对患者血清VEGF及组织VEGFmRNA水平检测对干细胞移植治疗糖尿病足的效果评价有一定的临床意义。

Objective To explore the expression of vascular endothelial growth factor （VEGF） in diabetic foot （DF） patients treated with autologous bone marrow stem cell transplantation and its significance.Methods Venous blood was collected from 30 DF patients treated with autologous bone marrow stem cell transplantation in weeks 2,4,8,12 before and after operation.Serum VEGF level was detected by ELISA,and VEGF mRNA expression in tissues around lesions by RT-PCR.Another 30 healthy subjects were enrolled as control group and serum VEGF and tissue VEGF mRNA determined.Results Serum VEGF level was significantly higher and tissue VEGF mRNA level lower in group DF than in control （P0.01）.Serum VEGF level reached the peak in weeks 2 after operation,then decreased gradually and returned to preoperative level in weeks 12 （P0.05）.VEGF mRNA level reached the peak in weeks 4,then decreased gradually,there was not significant difference between weeks 8 and preoperation,or between group DF in weeks 8 and control group （P0.05）.Conclusion The first 4 weeks after autologous bone marrow stem cell transplantation is the most vigorous stage for generation of blood capillary,skin regeneration and repairs.With the repair of some tissues,VEGF mRNA level falls gradually after 4 weeks.Therefore,determination of serum VEGF and tissue VEGF mRNA is of some clinical significance in evaluation of results of stem cell transplantation for DF.