自体外周血造血干细胞移植治疗糖尿病足的临床观察

Clinical observations on autologous transplantation of peripheral blood stem cells for treating patients with diabetic feet

目的观察自体外周血造血干细胞移植治疗糖尿病足的疗效及安全性。方法选取该院2008年9月～2009年8月重度糖尿病足患者共23例,治疗组12例(14条患肢),应用自体外周血造血干细胞移植治疗,采集自体外周血造血干细胞悬液标本约50 mL,在硬膜外麻醉或静脉全麻下在缺血下肢一次性按3 cm×3 cm间距做干细胞混悬液肌肉注射。对照组11例(共12条患肢),采用清创、换药、抗感染、改善血液循环等一般治疗。结果治疗3个月后,治疗组疼痛缓解率85.7%(12/14),冷感缓解率85.7%(12/14),间歇性跛行缓解率71.4%(10/14),溃疡愈合率64.3%(9/14)。对照组分别为25.0%(3/12),16.7%(2/12),8.3%(1/12),33.3%(4/12)。经统计学处理,P<0.05,差异有统计学意义。治疗组未发现并发症及不良反应。结论自体外周血造血干细胞移植治疗糖尿病足是一种简单、安全,有效,值得推广的方法。

【Objective】 To observe the efficacy and safety of autologous transplantation of peripheral blood stem cells（PBSCs） for treating patients with diabetic feet.【Methods】 Twenty-three patients with diabetic feet were choosed from September 2008 to August 2009 in the hospital.Fourteen limbs in 12 patients which was called treatment group were treated by autologous transplantation of peripheral blood stem cells.50 mL mixture of peripheral blood stem cells was collected and then injected into the skeletal muscles of the ischemic leg after epidural anesthesia or general intravenous anesthesia,3.0×3.0 cm interval from one point to another point.Twelve limbs in 11 patients which was called control group were treated by general treatment such as debridement,wound treatment,anti-infection and improving blood circulation.【Results】 The outcome was evaluated after 3 months of transplantation.The pain-relieve rate,improvement rate of cold feeling and intermittent claudication was 85.7%（12/14）,85.7%（12/14） and 71.4%（10/14） respectively in treatment group.The ulcer healing rate was 64.3%（9/14）.It was 25.0%（3/12）,16.7%（2/12）,8.3%（1/12） and 33.3%（4/12） respectively in control group.By statistical processing,P〈0.05,and the difference was statistically significant.No related complication or adverse effect was observed during 3 months of observation on treatment group.【Conclusions】 Autologous transplantation of peripheral blood stem cells is a simple,safe,and effective method which is worth promoting to treat patients with diabetic feet.