联合介入及自体外周血干细胞移植治疗下肢动脉缺血性疾病

Clinical Effect of Autologous Peripheral Blood Stem Cell Transplantation Combined with Interventional Therapy in Treatment of Chronic Lower Limb Ischemia

目的观察联合经皮腔内血管成形术(PTA)及自体外周血干细胞移植(ABSCT)治疗下肢动脉缺血性疾病可行性和近期效果.方法研究共入组48例下肢动脉缺血性疾病患者,依自愿原则分组,仅采用PTA治疗的19例患者为PTA组,单纯ABSCT组10例,PTA与ABSCT联合治疗的19例患者为联合治疗组.常规治疗方案3组相同,对3组患者的疼痛感、冷感、间歇跛行、踝肱指数(ABI)、侧支血管生成数量等方面的指标进行比较,从而判断3组患者的疗效差异.结果在疼痛感、冷感、间歇跛行3方面3组患者均明显降低,差异有统计学意义(P<0.05),ABI评分与侧支血管生成数评分方面,3组均升高,差异有统计学意义(P<0.05).与PTA及ABSCT组比较,联合治疗组在疼痛感、冷感、间歇跛行方面、ABI评分与侧支血管生成数评分改善更为明显(P<0.05).联合治疗组的有效率是89.5%,PTA组的有效率是78.9%,ABSCT组的有效率是60.0%,联合治疗组效果显著优于PTA组和ABSCT组(P<0.05).结论 PTA联合ABSCT治疗下肢动脉缺血性疾病安全、有效,疗效优于单纯PTA术及单纯ABSCT移植治疗.

Objective To investigate the clinical effect of percutaneous transluminal angioplasty（PTA）combined with autologous peripheral blood stem cell transplantation（ABSCT） in treating chronic lower limb ischemia.Me thods A total of 48 patients with chronic lower limb ischemia were voluntarily allocated into 3 groups： 19 patients treated with ABSCT combined with PTA, named as combined treatment group; 10 patients treated with ABSCT alone, named as single ABSCT group; and 19 patients treated with PTA alone, named as single PTA group. Patients in 3 groups received conventional therapy. Limb pain, cold feeling, intermittent claudication, ankle brachial index（ABI） and the number of collateral vessel formation of patients in 3 groups were assessed before and after treatment. Comparison of clinical effects was performed in 3 groups.Re s ults Limb pain scores, cold feeling scores and intermittent claudication scores of the patients in 3 groups significantly decreased after treatment（P〈0.05）. ABI score and the number of collateral vessel formation significantly increased（P〈0.05）. The combined treatment group showed obvious improvement in all the measured assessmentindicators（P〈0.05）. The total effective rate of combined treatment group was 89.5% while that in PTA group and ABSCT group were 78.9% and 60.0%, respectively. The total effective rate in combined treatment group was higher than that in both PTA group and ABSCT group（P〈0.05）. Conclus ion When treating chronic lower limb ischemia, combination use of PTA and transplantation of ABSCT is safe and effective, and its treatment effect is superior to single PTA as well as single ABSCT.