自体骨髓干细胞移植治疗下肢动脉缺血性疾病的疗效观察.doc

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1、自体骨髓干细胞移植治疗下肢动脉缺血性疾病的疗效观察作者：侯向前　吴学君　张精勇　金星　吕晓霞　钟振岳　张十一　董典宁　孙岩【摘要】　　目的：观察自体骨髓干细胞移植治疗下肢动脉缺血性疾病的临床疗效及影响因素。方法：28例下肢动脉缺血患者，均抽取自体骨髓血，体外提取单个核细胞，行缺血下肢局部肌肉注射，术后观察各项指标综合评估。将患者分为高浓度注射组和低浓度注射组，比较两组移植前后缺血改善情况。结果：28例患者总的疼痛缓解率及麻木感和冷感缓解率均为100%，5例溃疡出现愈合迹象，移植后临床评分（10.96±2.09）低于移植

2、前（14.25±2.41），P＜0.05；高浓度注射组注射前后评分差值（3.92±1.16）大于低浓度注射组(2.81±1.52，P＜0.05。除1例于术后3个月出现浅静脉曲张外，未发现明显并发症。结论：自体骨髓干细胞移植治疗下肢动脉缺血性疾病是一种安全、有效的手段。干细胞提取的数量、动脉缺血的范围，尤其是干细胞注射浓度对于其治疗效果有重要影响。【关键词】骨髓祖代细胞　移植　自体　腿　缺血　　Clinicalefficacyandinflucingfactorsofautologoustransplantationof

3、bonemarrowmononuclearcellsinthetreatmentoflowerextremityischemicdisorders【ABSTRACT】Objective：Toobservetheclinicalefficacyandanalyzetheinflucingfactorsofautologoustransplantationofbonemarrowmononuclearcellsinthetreatmentoflowerextremityischemicdisorders.Methods：T

4、otally28casesweretreatedbyautologoustransplantationofbonemarrowmononuclearcells.Afteraspirationofbonemarrowbloodfromtheiliums，themononuclearcellswereseparatedandtheninjectedintotheskeletalmusclesoftheischemiclegs.Theclinicalandlaboratoryfindingsweremonitoredafte

5、rthesurgery.Thenthecasesweredividedintotwogroupsbytheconcentrationofthebonemarrowmononuclearcellsinjectedintothemuscles.Theimprovementdegreesofthetwogroupswerecompared.Results:Thelowlimbpainalleviatingratewas100%aswellastheskinturningwarmandtheinsensiblefeelinga

6、lleviatingrate,therewasthesignofulcerhealingin5case.Theclinicalscoreafterthetransplantation(10.96±2.09)waslowerthanthatbeforethetransplantation(14.25±2.41),P＜0.05.Thedifferencevalueofthegrouptreatedwithhighermononuclearcellsbeforeandaftertheplantationissignifica

7、ntlyhigherthanthatofthegroupwithlowermononuclearcells.No5complicationswasfoundexcept1caseappearedsuperficialvaricosis.Conclusions:Autologoustransplantationofbonemarrowmononuclearcellscouldbeasafeandeffectivemethodfortreatingpatientswithlowerextremityischemicdiso

8、rder.Thequantityofthemononuclearcells,theextentofischemia,especiallytheconcentrationofthemononuclearcellsinjectedintothemusclessignificantlyinfluenttheresultofthetrea