血管成形与脐带干细胞移植治疗糖尿病足：3个月血管造影评价

背景：目前对糖尿病继发肢体动脉闭塞尚无有效的药物治疗,最终多导致截肢,预后很差。 目的：以血管成形联合人脐带间充质干细胞移植治疗糖尿病足,3个月后行血管造影评价效果。 方法：确诊症状严重伴有下肢动脉不同程度病变的Fontain Ⅳ期糖尿病足40例52条患肢,对照组12例患者18条患肢给予单纯介入治疗,实验组28例34条患肢给予介入联合人脐带间充质干细胞经导管灌注及溃疡周围注射治疗,随访3个月。 结果与结论：治疗后患肢冷感、疼痛、麻木等临床症状持续改善,患肢皮温、踝肱指数值及跛行距离均增加。治疗3个月后复查造影,新生血管增多,溃疡逐渐愈合或缩小,输注前后未出现严重并发症和不良反应。说明采用血管成形联合人脐带间充质干细胞移植治疗糖尿病足,方法可行、安全,近期疗效满意。

Human umbilical cord mesenchymal stem cell transplantation combined with angioplasty for diabetic foot: 3 months angiographic evaluation

BACKGROUND:At present, there is no effective drug for the treatment of diabetic arteniosclerosis obliterons, and most of the patients have to receive amputation, and have poor prognosis. OBJECTIVE:To treat the diabetic foot with human umbilical cord mesenchymal stem cells transplantation combined with angioplasty, and to perform the angiographic evaluation at 3 months after operation. METHODS:Forty cases (52 limbs) diagnosed with severe symptoms of Fontain Ⅳ diabetic foot accompanied with varying degrees of lower extremity arterial disease were included. The 12 cases (18 limbs) in the control group received simple interventional treatment, and 28 cases (34 limbs) in the experimental group were given human umbilical cord mesenchymal stem cells endovascular infusion and injection around the ulcer. Then all the patients were followed-up for 3 months.   RESULTS AND CONCLUSION:Local cool-feeling, pain and numbness after treatment were improved continuously in a certain extent; skin temperature, ankle-brachial pressure index and claudication distance were improved persistently. Re-examination angiography at 3 months after treatment showed that the neovessels were increased significantly and the ulcer was healed or decreased gradually. No serious complications and adverse reactions were observed before and after infusion. The results indicate that human umbilical cord mesenchymal stem cell transplantation combined with angioplasty is a safe, effective and satisfactory method for severe diabetic foot.