脐血干细胞移植治疗糖尿病下肢缺血的可行性

Feasibility of umbilical cord blood stem cell transplantation for the treatment of diabetic lower limb ischemia

背景:糖尿病下肢缺血患者病变大多会累及下肢远端小动脉,导致常规治疗方法难度增加。目的:探讨脐血干细胞移植治疗糖尿病下肢缺血大鼠的效果和安全性。方法:建立糖尿病下肢缺血大鼠模型,沿股动脉走向,在模型大鼠下肢选取5点,每点注射人脐带间充质干细胞悬液20μL。移植后1,2,4周,检测经皮氧分压以及缺血部位血管密度和血管内皮生长因子水平,并记录不良反应发生情况。结果与结论:移植后1,2,4周大鼠经皮氧分压以及缺血部位血管密度和血管内皮生长因子水平整体均呈现出不断上升的情况,与移植前比较差异均有显著性意义(P<0.05)。移植后所有动物均未出现皮肤出血和皮炎以及局部红、肿、热、痛等炎症反应,相关脏器均未出现瘤样生长。结果表明脐血干细胞移植治疗糖尿病下肢缺血,可显著改善下肢缺血症状,且安全性高,具有一定的应用可行性。

BACKGROUND： Diabetic lower limb ischemia is prone to involve distal lower limb arteries, and a conventional treatment is often unable to obtain the ideal effect. OBJECTIVE： To investigate the effect and safety of umbilical cord blood stem cell transplantation in the treatment of diabetic lower limb ischemia. METHODS： A diabetic rat model of lower limb ischemia was established, and along the femoral artery, five pointswere selected for injection of human umbilical cord mesenchymal stem cell suspension, 20 μL per point. At 1, 2, 4 weeks after transplantation, transcutaneous oxygen pressure, vascular density and vascular endothelial growth factor level in the ischemic region, and incidence of adverse reactions were recorded. RESULTS AND CONCLUSION： At 1, 2 and 4 weeks after transplantation, the transcutaneous oxygen pressure, vascular density and vascular endothelial growth factor level in the ischemic region were found increasing, which were significantly different from those before transplantation（P〈0.05）. At different time after transplantation, all animals had no inflammatory reactions such as skin bleeding and dermatitis, and local red, swelling, hot, pain, and had no tumor-like growth in organs. These findings indicate that umbilical cord blood stem cell transplantation can safely and significantly improve symptoms of diabetic lower limb ischemia, which has certain application feasibility.