自体骨髓干细胞移植治疗严重下肢动脉缺血52例疗效分析

目的]评估自体骨髓干细移植治疗严重下肢动脉缺血的临床效果及安全性.方法]自体骨髓单个核细胞肌注移植术对52例严重下肢动脉缺血患者(共59条惠肢)治疗,观察患者治疗前后数字疼痛评分法(numericalrating scalle,NRS)评分、冷感评分(cold sensation,CS)、跛行距离(distance of claudication,DOC)、踝肱指数(ankle/brachial index,ABI)、经皮氧分压(transcutaneous oxygen pressure,TcPO2)、足部溃疡面积及肝肾功能、肿瘤指标的变化.结果]治疗前平均NRS评分、CS评分、DOC、ABI、TcPO2测定分别为(7.06±1.50)分、(3.42±0.68)分、(160±58)m、0.27±0.11、(14.8±7.6) mmHg;患者随访12个月,治疗后6周上述指标分别为(2.64±0.71)分、(1.20±0.64)分、(682±165)m、0.34±0.18、(22.3±7.8) mmHg,与治疗前相比差异有统计学意义(P＜0.05)；1年后分别为(2.44±0.86)分、(0.92±0.51)分、(920±387)m、0.38±0.22、(30.2±8.5)mmHg,与治疗前比较差异有统计学意义(P＜0.05).所有患者术后未发现肝肾功能改变、恶性肿瘤、血管瘤形成等并发症.结论]自体骨髓干细胞移植治疗严重下肢动脉缺血操作简单、疗效满意,并发症少,值得推广.

Analysis of the Efficacy of Autologous Bone Marrow Stem Cell Transplantation for the Treatment of52 Patients with Serious Lower Limb Ischemia

Objective]To evaluate the clinical efficacy and safety of autologous bone marrow-mononuclear stem cell transplantation for the treatment of serious lower limb ischemic. E Methods] Totally 52 patients（59 diseased limbs） with serious lower limb ischemia underwent transplantation of autologous bone marrow-mononuelear stem cell into ischemic muscles via intramuscular injection. Numericalrating scale（NRS） score, cold sensation（CS）, dis- tance of claudication（DOC）, ankle/brachial index（ABI）, transcutaneous oxygen pressure（TcPOz ）, foot skin ul- cer, function of liver and kidney and tumor markers of patients were observed before and after treatment. ~Re- sults] The mean NR$ scores, CS scores, DOC, ABI and TcPOz before treatment were 7.06-1-1.50, 3.42-1-0.68, （160-1-58）m, 0.27~z0.11 and （14.8!7.6）mmHg, respectively. All patients were followed up for 12 months. A- bove indicators 6 weeks after treatment were 2.64~0.71, 1.20~0.64, （682~165）m, 0.34~0.18 and （22.3~ 7.8）mmHg respectively, and there were significant differences between 6 weeks after treatment and before treat- ment（ P d0.05）. After one year of treatment, above indicators were 2.44~0.86, 0. 92-1-0. 51, （920~387）m, 0. 38：：0.22 and （30.2q-8.5）mmHg respectively, and there were also significant difference between one year after treatment and before treatment（ P d0.05）. No complications such as alterations of liver and kidney function, ma- lignant neoplasm and angioma were found in all patients. Conclusion] Autologous bone marrow-mononuclear stem cell transplantation for the treatment of serious lower limb ischemia is simple and effective, and has less complica- tions, so it is worthy to be popularization.