外周血干细胞移植治疗慢性下肢动脉缺血性疾病

Peripheral blood stem cells transplantation for treatment of chronic lower limb ischemia

目的观察自体外周血干细胞移植治疗慢性下肢缺血性疾病的疗效。方法应用自体外周血干细胞移植治疗46例慢性下肢缺血性疾病的患者。结果42例小腿疼痛缓解，小腿冷、凉感觉消失；35例足部疼痛改善；29例足部冷、凉感消失；4例术后4周因为小腿中段以下出现坏死导致截肢。42例保肢病例，干细胞移植术后3个月，间歇性跛行距离由（87．45±41．22）m增加到（348．52±147．24）m，下肢皮温由（28．52±0．51）℃增加到（33．56±0．62）℃，踝肱指数（ABI）由（0．48±0．06）增加到（0．75±0．07），移植前后3项指标的差异均具有统计学意义（P〈0．05），移植后优于移植前。术后6个月和12个月下肢动脉影像学检查显示，37例均有不同程度的新生侧支血管形成。结论自体外周血干细胞移植治疗下肢缺血性疾病是一种有效的方法，尤其对远端动脉流出道差的患者是一种较好的治疗手段。

Objective To investigate the efficiency of autologous transplantation of peripheral blood stem cell for treatment of patients with chronic lower limb ischemia. Methods Forty-six patients with chronic lower limb ischemia were treated by autologous peripheral blood stem cell transplantation. Results Forty- two patients had pain relief on legs, and cold and cool feelings in lower limbs disappeared. Thirty-five pa- tients had pain relief on feet, and 29 of them had disappearance of cold and cool feelings. Due to necrosis in middle and lower part of leg, 4 patients took extremity amputation after 4 weeks of the transplantation. In the 42 patients who kept their legs 3 months after transplantation, the distance of anginaeruris extended from （87.45 ±41.22） m to （348.52 ± 147.24） m, skin temperature increased from（28.52 ±0.51 ） ℃ to（33.56 ±0. 62 ） ℃, and anklebraehial index （ABI） increased from （ 0.48 ± 0.06 ） to （ 0. 75 ± 0.07 ）. There were statistical differences, and the scores of the distance of anginacruris, skin temperature, and ABI after trans- plantation were better than before, six months after transplantation autobiography of lower extremity was used, and neonatal lateral vessels of different degrees were found in 37 patients. Conclusion Autologous transplantation of peripheral blood stem cell is a simple, safe, and effective method, especially in treating patients with lower limb ischemia in which no arterial reconstruction is feasible.