摘要
目的:对血栓闭塞性脉管炎患者行自体外周血干细胞移植治疗前后的相关指标进行综合评估。方法:选择2004-01/11解放军第四六三医院细胞治疗中心收治的自愿接受自体外周血干细胞移植的血栓闭塞性脉管炎患者8例,双下肢病变7例,单肢病变1例,共累及15只足,均有严重足部静息痛。其中足趾溃疡2例,坏疽3例。全部患者均给予重组人粒细胞集落刺激因子450-600μg/d,皮下注射,进行外周血干细胞动员5d,第6天用COBE6.1血细胞分离机单采干细胞,总量82-106mL,单个核细胞散(129.8-376.7)×109L-1,CD34+细胞0.32%-0.48%。将干细胞悬液制备为(1-2.8)×1011L-1。细胞浓度,按3cm×3cm距离进行缺血肢体移植术。术后对患者经皮氧分压、皮温、踝眩指数和足底深感觉、主观感觉、溃疡及坏疽情况、数字减影血管造影结果及不良事件和副反应进行综合评估,与移植前进行对照。结果:接意向处理分析,8铡患者均进人结果分析。随访时间3个月。①经皮氧分压:6例患者干细胞移植3个月后足部经皮氧分压较移植前有不同程度的改善。②皮温:移植后1个月患者皮温均有不同程度上升(1-5℃)。③踝肱指数:移植后3个月有3例患者足部血流渡幅较移植前有不同程度的增加(为0.22/0.16,0.82/0.43,0.76/0.40)。④足底深感觉:移植后3个月有3例患者较移植前轻度改善。⑤主观感觉:7例患者于术后3-21d疼痛减轻或消失,8例足部冷感在2-28d明显好转。⑥溃疡及坏疽情况:移植后8-16周2例足部溃疡愈合。⑦数字减影血管造影结果:1例患者于干细胞移植后3个月行动脉造影,可见下肢及足部有新生侧支血管形成。⑧不良事件和副反应:6例患者应用细胸动员时感骨骼和肌肉酸痛,移植后3d8例患者均感足部及小腿腓肠肌轻度胀痛,但能耐受。结论:自体外周血干细胞移植治疗血栓闭塞性脉管炎,能有效地增加患者的下肢血流量,改善症状,使
AIM: To synthetically evaluate the interrelated indices of pre-and post-transplantation of autologous peripheral blood atem cells(PBSCs) for thromboangiitis obliterana. METHODS: Eight patients with thromboangiitis obliterans voluntarily received autologous PBSC transplantation in the Center for Cell Treatment, the 463 Hospital of Chinese PLA between January and November 2004. consisting of 7 with lesion of lower limbs and 1 with lesion of single limb for a total of 15 feel with severe foot rest pain, and including 2 with toe ulcer and 3 with gangrene. All the patients received subcutaneous injection of recombinant human granulocyte colony-stimulating factor(rhG-CSF) 450 to 600 üg per day for 5 days to mobilize the PBSCs. On the sixth day, PBSCs were collected by COBE 6, 1 Spectra Version(a syatem for separation of blood cells) for 82 to 106 mL. mononuclear cells(MNCs) from 129. 8 × 109L-1 to 376.7×109 L-1, CD34 +cells from 0.32% to 0.48%. The PBSC suspension was made into a concentration of (1 to 2. 8) ×1011 L-1, and the PBSCs were transplanted into the ischemic limbs and foot intramuscularly in a 3 × 3 cm distance. The patients' transcutaneous oxygen partial pressure(TcPO2). skin temperature, ankle/braehial index(ABI), deep plantar sensation,subjective sensation, foot ulcer and gangrene, results of digital subtract ion angiography (DSA). adverse events and side responses were monitored after transplantation so as lo compare with those before transplantation. RESULTS: According lo the intention-to-treat analysis, all the 8 patients were involved in resull analysis and followed up for 3 months. (1) The foot TcPO2 was differentially improved in 6 cases 3 months after transplantation as compared with before transplantation. (2) At 1 month after transplantation, the skin temperature increased by 1 ℃ to 5 ℃ in the 8 patients as compared with before transplantation.(3)At 3 months after transplantation. wave amplitude of blood flow in the Mil was increased differently in 3 patients. 0. 22/0. 16.0.82/0.43 and 0.
出处
《中国临床康复》
CSCD
北大核心
2005年第18期41-43,共3页
Chinese Journal of Clinical Rehabilitation
