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自体外周血干细胞移植治疗下肢动脉硬化性闭塞症
引用本文:黄平平,李尚珠,韩明哲,肖志坚,杨仁池,邱录贵,钱冠清,付仁敏,郑亚丽,刘春华,徐秀强,李君凡,韩忠朝.自体外周血干细胞移植治疗下肢动脉硬化性闭塞症[J].中华血液学杂志,2003,24(6):308-311.
作者姓名:黄平平  李尚珠  韩明哲  肖志坚  杨仁池  邱录贵  钱冠清  付仁敏  郑亚丽  刘春华  徐秀强  李君凡  韩忠朝
作者单位:300020,天津,中国医学科学院中国协和医科大学血液学研究所、血液病医院,国家干细胞工程技术研究中心
基金项目:国家攀登计划资助(95-专-10);国家863计划资助(2001AA215311;2002AA223354)
摘    要:目的评价动员后自体外周血干细胞移植治疗下肢动脉硬化性闭塞症(ASO) 的临床疗效及部分影响因素.方法确诊严重ASO患者1例,予rhG-CSF 300μg皮下注射,每日2次,进行外周血干细胞动员,第5天用血细胞分离机单采干细胞,配成干细胞混悬液.将干细胞混悬液肌肉注射进行双下肢移植(3×109细胞/肢).44 d后给病情较重的左下肢第2次移植相同的细胞数.观察3个月,进行各项指标综合评估.结果外周血干细胞移植后,患者疼痛、患肢冷感、间歇性跛行、溃疡明显好转,左右足踝压指数(ABI)分别由0.49,0.69升为0.50,0.85.移植后1个月末梢血流波幅(11.90±10.95)mm]和激光多谱勒扫描血流灌注量(0.49±0.16)PU]较移植前分别为(1.70±1.95)mm,(0.27±0.08)PU]显著改善(P<0.01). 数字减影下肢动脉造影结果显示新侧支血管形成明显增加(评分结果为3).未出现并发症和不良反应.结论采用动员后的外周血干细胞移植治疗ASO患者,方法简单、安全、有效,值得推广应用和深入研究.

关 键 词:自体外周血干细胞移植  治疗  下肢动脉硬化性闭塞症  疗效观察
修稿时间:2003年2月15日

Transplantation of autologous peripheral blood stem cells for the treatment of lower limb arteriosclerosis obliterans
HUANG Ping-ping,LI Shang-zhu,HAN Ming-zhe,XIAO Zhi-jian,YANG Ren-chi,QIU Lu-gui,QIAN Guan-qing,FU Ren-min,ZHENG Ya-li,LIU Chun-hua,XU Xiu-qiang,LI Jun-fan,HAN Zhong-chao.Transplantation of autologous peripheral blood stem cells for the treatment of lower limb arteriosclerosis obliterans[J].Chinese Journal of Hematology,2003,24(6):308-311.
Authors:HUANG Ping-ping  LI Shang-zhu  HAN Ming-zhe  XIAO Zhi-jian  YANG Ren-chi  QIU Lu-gui  QIAN Guan-qing  FU Ren-min  ZHENG Ya-li  LIU Chun-hua  XU Xiu-qiang  LI Jun-fan  HAN Zhong-chao
Institution:Institute of Hematology & Blood Diseases Hospital, National Research Center of Stem Cell Engineering & Technology, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China.
Abstract:OBJECTIVE: To evaluate the clinical efficacy of mobilized autologous peripheral blood stem cells (PBSC) transplantation in a 48 years old patient with lower limb arteriosclerosis obliterans (ASO). METHODS: rhG-CSF 600 micro g/d for 5 days to mobilize stem cells. On the fifth day, PBSC were collected with a Version 4 blood-cells separator. Three hours late, the PBSC were intramuscularly injected into the ischemic areas of the two lower limbs (3 x 10(9) cells per limb). The clinical and laboratory findings were monitored every week for 3 months. Forty-four days after the implantation, left lower limb with severe ASO was given an additional implantation of the same number of cells as the first time. RESULTS: The peripheral blood CD(34)(+) cells were increased from 0.18% to 0.75% after 5 days of rhG-CSF mobilization. Three months after the first stem cell transplantation, severe pain lameness, local cool-feeling and ulcer were improved, and ABI increased from 0.49, 0.69 to 0.50, 0.85, the amplitude of blood flow and laser Doppler blood perfusion were also significantly improved (P < 0.01). At the same time, digital subtraction angiographic scores for new collateral vessel formation were showed as + 3(rich). No related complication or adverse effect were observed during the 3-month observation. CONCLUSION: Transplantation of mobilized autologous PBSC might be a simple, safe, and effective method for the treatment of ASO.
Keywords:Hematopoietic stem cell transplantation  Transplantation  autologous  Arteriosclerosis obliterans
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