自体外周血干细胞移植治疗糖尿病下肢缺血效果观察

Autologous peripheral, blood stem cells transplantation for the treatment of diabetic vascular disorder in lower extremities

目的探讨自体外周血干细胞（PBSC）移植治疗糖尿病性下肢缺血的疗效。方法应用自体PBSS移植治疗18例30条糖尿病性下肢缺血。采用主观、客观评价指标对疗效进行观察评定。结果自体PBSC移植后1个月患者疼痛、冷感、麻木症状明显改善，改善率分别为96．7％（29／30）、100％（30／30）、95．8％（23／24）；间歇性跛行明显缓解，总有效率为76．9％（10／13）。3个月后踩肱指数（ABI）升高，由术前的0．60±0．11增加到术后的0．71±0．12，差异有统计学意义（t=-6．882，P〈0．01）。93．3％（28／30）的患者皮氧分压不同程度地升高；同时患者的足部感染得到控制，溃疡或足趾坏疽好转或愈合。移植后所有患者均未出现并发症和明显不良反应。结论自体PBSC移植治疗糖尿病性下肢缺血是一种相对简单、安全、有效的方法。

Objective To investigate the efficiency of autologous transplantation of peripheral blood stem cells for treatment of patients with diabetic lower limb ischemia. Methods Eighteen patients of type 2 diabetes with diabetic lower limb ischemia （30 legs ） were treated by autologous transplantation of peripheral blood stem cells. Results The limb pain, cool feeling and numbness feeling improved significantly after PBSC transplantation, the improvement rate were 96.7%, 100.0% and 95.8% respectively. Intermittent claudication was also relieved significantly, total remission rate was 76.9%. The ABI and TcPO2 of patients increased significantly at 3 months after transplantation. After the transplantation ABI raised from 0. 60 ± 0. 11 to 0. 71 ± 0. 12（t = - 6. 882 ,P 〈0. 01 ）. 93.3% of patients＇ TcPO2 raised in different degrees. The foot infections were well controlled. Ulcer or toes gangrene got better or healed. No obvious complications or adverse reaction were observed after the transplantation. Conclusion Autologous transplantation of peripheral blood stern cells shows to be a simple, safe and effective method in treating patients with diabetic lower limb ischemia.