脐血单个核细胞移植治疗糖尿病足23例

背景：以自体骨髓、外周血间充质干细胞移植治疗糖尿病足,对缺血性病变及周围神经损伤所致临床症状有改善作用。目的：观察脐血单个核细胞移植治疗糖尿病足病缺血及神经损伤的疗效。对象：选取2006/2010住院行脐血单个核细胞移植治疗的糖尿病足病患者23例,脐血单个核细胞稀释后双下肢肌肉内注射,每点1~3mL,间隔约3cm。单个肢体移植1.23×108~1.06×109个,共计38条肢体。结果与结论：移植后踝肱指数升降不一,移植后6个月疼痛评分及冷感评分明显改善,间歇性跛行及皮肤温度、经皮氧分压治疗后3,6个月比较差异均有显著性意义;对神经病变损伤自觉症状评分、临床检查评分、振动觉阀值移植后6个月与移植前比较差异有显著性意义。腓浅神经、胫神经感觉神经传导速度,腓总神经、胫神经运动神经传导速度,在移植后3个月与移植前比较,差异无显著性意义（P〉0.05）,移植6个月与移植前相比较有升高,差异有显著性意义（P〈0.05）。可见脐血单个核细胞可以改善糖尿病缺血性病变及周围神经病变的临床症状及客观指标。

Umbilical cord blood stem cell transplantation for the treatment of diabetic foot in 23 cases

BACKGROUND： Transplantation of autologous bone-marrow mononuclear cells or umbilical cord derived mesenchymal stem cells for treatment of diabetic foot has been widely developed at present, which showed good curative effect on ischemic lesions and peripheral neuropathy. OBJECTIVE： To observe the effect of umbilical cord derived mononuclear cells on diabetic ischemic lesions and peripheral neuropathy.METHODS： Twenty-three patients with diabetic foot received umbilical cord derived mononuclear cells injection into both lower extremities intramuscular （1-3 mL/site） for 3 cm distance after dilution. The number of implanted cells was 1.23×108-1.06×109 per leg （totally 38 limbs）. RESULTS AND CONCLUSION： There was no significant difference in ankle/brachial index after treatment. There were significant differences in angina cruris, skin temperature and transcutaneous oxygen partial pressure after 3 or 6 months treatment. After treatment for 6 months, the pain score and thermoesthesia score were improved and there were significant differences in rational symptom score, clinical examination score, the value of pallesthetic sensibility and the conduction velocity of motor/sensory nerves. The clinical symptoms and objective indexes of diabetic ischemic lesions and peripheral neuropathy were improved after umbilical cord derived mononuclear cells implantation.