临床医学论文自体外周血干细胞移植治疗老年人慢性下肢缺血临床研究

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1、临床医学论文•自体外周血干细胞移植治疗老年人慢性下肢缺血临床硏究【摘要】目的：评价外周血干细胞移植治疗老年人慢性下肢缺血的临床疗效。方法：应用自体外周血干细胞移植治疗慢性下肢缺血10例，其中下肢动脉硬化闭塞症4例，糖尿病足3例，血管闭塞性脉管炎3例。患肢12条中左5条，右7条。均予G・CSF300/zg/d皮下注射，连用4〜6天行外周血干细胞动员，当外周血白细胞计数＞30xl09/L时，用血细胞分离机单采干细胞，配成干细胞悬液。部分干细胞悬液直接注射至患肢肌肉内，其余干细胞悬液经球囊导管技术灌注至患肢末梢动脉内。结果：患肢疼痛和冷感觉改善率为100%。间歇性跛行3例行走距离明显增加。移植后1个

2、月，5例7条下肢数字减影血管造影结果示均有新生侧支血管形成。结论：外周血干细胞移植治疗慢性下肢缺血安全、简单、有效。【关键词】慢性下肢缺血造血干细胞自体Clinicalstudyontransplantationofautologousperipheralbloodstemcellsforthetreatmentofoldpatientswith1ower1imbchronicischemia[Abstract]Objective：Toevaluatetheclinicalefficacyofmobi1izedautologousperipheralbloodstemcells(PBSC)tr

3、ansplantationinoldpatientswith1ower1imbchronicischemia.Methods:18oldpatients(20legs)with1ower1imbchronicischemiaweretreatedbyautologoustransplantationofmobi1izedPBSCfromOct・2004toMar・2006・Theywere12menand6women.10patientsaffectedby1ower1imbarteriosclerosisobiitcrans(ASO),8patientsbydiabeticfeet.Them

4、eanageswas69years(from62to82).Theyal1receivedthesamedoseofgranulocytecolony・stimulatingfactor(G-CSF)300/zg/dbyhypodermicinjectiontomobi1izcstemcellsfor4~6days.PBSCwereseparatedbyablood-celIsseparatorintosuspendingliquidwhenthecountnumberofwhitebloodcellinperipheralbloodexceed30xl09/L・PartofthePBSCsu

5、spensionwithouttreatmentwasinjectedintotheskeletalmusclesoftheischemiclegandtheremainderwasinfusedintoischemia-relatedarteryofthesamelegthroughballooncenterlumcn.Results:Afterthestemeel1transplantation,thegeneralrateofrelievingpainandlocalcool-feelinginlegwas100%,thewalkingdistanceof14patientswithin

6、termittentclaudicationwasobviouslylonger.Onemonthafterthetransplantation,angiographyshowedanoticeableincreaseinvisiblecollateralvesselsin6patientswith71imbswhohadDSAangiographyfollow-up.Norelatedseverecomplicationsoradverseeffectswereobservedinthisgroup.Conclusion：Transplantationofmobi1izedautologou

7、sPBSCmightbesimple,safeandeffectiveforthetreatmentofoldpatientswith1ower1imbchronicischemia,butitslongtermeffectneedfollowupmorelongertimcandeveninmorepatients・[Keywords]Limbchronicischemia;Hematopoie