脐血干细胞移植及血管成形治疗糖尿病下肢缺血性疾病

Umbilical cord blood stem cell transplantation and endovascular treatment of diabetic lower limb ischemic disease

背景:近年来介入治疗因其成功率高、疗效好、创伤小已被广泛认可,但由介入治疗引起的血管内膜损伤尚无有效的治疗手段,致使术后远期发生严重再狭窄。干细胞移植技术的出现为促进受损血管内皮功能修复、再内皮化及辅助恢复缺血组织血供带来了新的曙光。目的:总结近年来有关脐血干细胞移植技术及腔内血管成形术治疗糖尿病下肢缺血性病变的研究进展。方法:使用计算机检索2000年1月至2015年3月PubM ed、CNKI数据库中相关文章,检索词为"human umbilical cord blood stem cell transpltation,percutaneous transluminal angioplasty,diabetic lower limb ischemia,restenosis"及"人脐血干细胞移植、血管腔内成形术、糖尿病下肢缺血、再狭窄"。将符合研究目的的文献分类筛选并进行评价,初检获得216篇相关文献,最终纳入44篇文献进行分析。结果与结论:通过对人脐血干细胞移植及血管成形术这两种治疗方式的疗效及远期预后分析比较,得出脐血干细胞移植联合血管成形术疗效优于单纯干细胞移植或单纯介入治疗,能够促进侧支循环建立、改善受损内皮功能及降低介入治疗后再狭窄发生。

BACKGROUND： In recent years, interventional therapy because of its high success rate, good curative effect,little trauma has been widely recognized, but vascular intimal injury due to interventional therapy still has no effective treatment, resulting in long-term postoperative severe restenosis. Stem cell transplantation has brought a new drawn for the repair of impaired endothelial function, reendothelialization and aided restoration of the blood supply to ischemic tissues.OBJECTIVE： To summarize the recent progress in umbilical cord blood stem cells transplantation and endovascular treatment for treatment of diabetic lower limb ischemic disease.METHODS： A computer-based search of PubM ed and CNKI was performed for relevant articles published from January 2000 to March 2015 using the keywords of ＂umbilical cord blood stem cell transplantation, percutaneous transluminal angioplasty, diabetic lower limb ischemia, restenosis＂ in English and Chinese. Totally 216 relevant literatures were initially obtained, and 44 articles were ultimately included.RESULTS AND CONCLUSION： By comparing the therapeutic efficacy and long-term prognosis of umbilical cord blood stem cell transplantation and endovascular treatment, it is concluded that umbilical cord blood stem cell transplantation combined with endovascular treatment is better than either of them alone, which can promote theestablishment of collateral circulation, improve the impaired endothelial function and reduce the occurrence of restenosis after interventional therapy.