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本帖最后由 细胞海洋 于 2010-5-29 06:47 编辑 * s+ [+ \' ?. |) z G. L
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黄平平 李尚珠 韩明哲 肖志坚 杨仁池 邱录贵 钱冠清( m. o& t% I4 V, l) _1 Y: C
付仁敏 郑亚丽 刘春华 徐秀强 李君凡 韩忠朝
0 u$ ^. b8 |3 f; S) E9 x# J 【摘要】 目的 评价动员后自体外周血干细胞移植治疗下肢动脉硬化性闭塞症(ASO) 的临床疗. B Q/ t. [- Y$ l, n6 C' ~, i
效及部分影响因素。方法 确诊严重ASO 患者1 例,予rhG2CSF 300μg 皮下注射,每日2 次,进行外周4 M% A1 ]! Y$ Z* I2 ?! |5 R8 g
血干细胞动员,第5 天用血细胞分离机单采干细胞,配成干细胞混悬液。将干细胞混悬液肌肉注射进
- R3 P! ?5 b: U: ` M行双下肢移植(3 ×109 细胞P肢) 。44 d 后给病情较重的左下肢第2 次移植相同的细胞数。观察3 个+ c8 e9 }6 i& j* a) `
月,进行各项指标综合评估。结果 外周血干细胞移植后,患者疼痛、患肢冷感、间歇性跛行、溃疡明, L$ x0 w I: M! n1 _5 K5 e
显好转,左右足踝压指数(ABI) 分别由0. 49 ,0. 69 升为0. 50 ,0. 85。移植后1 个月末梢血流波幅[ (11. 90- g# Q3 q' `& z: e5 ~
±10. 95)mm]和激光多谱勒扫描血流灌注量[ (0. 49 ±0. 16) PU]较移植前[ 分别为(1. 70 ±1. 95) mm ,; n2 ?) L- R( q6 S. W' s
(0127 ±0. 08) PU]显著改善( P < 0. 01) 。数字减影下肢动脉造影结果显示新侧支血管形成明显增加(评
8 m" v a3 L1 r分结果为3) 。未出现并发症和不良反应。结论 采用动员后的外周血干细胞移植治疗ASO 患者,方 w7 D. E# s( }
法简单、安全、有效,值得推广应用和深入研究。
; |% x0 J$ u% A7 H- L1 U. ] 【关键词】 造血干细胞移植; 移植,自体; 动脉硬化,闭塞性 J1 R4 }- ]& L
Transplantation of autologous peripheral blood stem cells for the treatment of lower limb arteriosclerosis ob2% T. S5 Z! ~$ {& `- R4 r* j d
literans HUANG Ping2ping ,LI Shang2zhu , HAN Ming2zhe , XIAO Zhi2jian , YANG Ren2chi ,QIU Lu2gui , QIAN
0 X, b4 S+ p! S% s# sGuan2qing , FU Ren2min , ZHENG Ya2li , LIU Chun2hua , XU Xiu2qiang , LI Jun2fan , HAN Zhong2chao. Insti2
1 Z: w+ |) g' [ etute of Hematology &Blood Diseases Hospital ,National Research Center of Stem Cell Engineering & Technology , Chi2
0 M9 }; n% n9 a5 f; e+ S# s1 J9 ^nese Academy of Medical Sciences & Peking Union Medical College , Tianjin 300020 , China1 N7 z5 p J: F5 |
Corresponding author : HAN Zhong2chao0 v! h& U2 d2 o/ w
【Abstract】 Objective To evaluate the clinical efficacy of mobilized autologous peripheral blood stem cells1 h3 @+ C0 d6 C* L0 e1 e
(PBSC) transplantation in a 48 years old patient with lower limb arteriosclerosis obliterans (ASO) . Methods rhG2& W8 J; L2 I( a/ c6 j
CSF 600μgPd for 5 days to mobilize stem cells. On the fifth day , PBSC were collected with a Version 4 blood2cells
% q! I) ^% @0 l( S: S5 R4 V# Iseparator. Three hours late , the PBSC were intramuscularly injected into the ischemic areas of the two lower limbs- i `9 c# n- J9 c# M
(3 ×109 cells per limb) . The clinical and laboratory findings were monitored every week for 3 months. Forty2four8 f1 r6 n0 M* M4 c0 _
days after the implantation , left lower limb with severe ASO was given an additional implantation of the same number
, v/ n$ ?' I1 mof cells as the first time. Results The peripheral blood CD34
" Z6 M- j/ Z( u( G# `2 }; C& q+ cells were increased from 0. 18 % to 0. 75 % after 5
: E! y: ~+ X: [! k4 ddays of rhG2CSF mobilization. Three months after the first stem cell transplantation , severe pain lameness , local' c, o6 a R- W$ x! m& Z
cool2feeling and ulcer were improved , and ABI increased from 0. 49 ,0. 69 to 0. 50 ,0. 85 , the amplitude of blood
9 Z/ o% y* p3 g+ Z* m' X( I$ Uflow and laser Doppler blood perfusion were also significantly improved( P < 0. 01) . At the same time , digital sub29 q+ d# k! u3 b! Y% f" ?
traction angiographic scores for new collateral vessel formation were showed as + 3(rich) . No related complication A' l3 c: g- s. O" \7 U0 P( Y# z
or adverse effect were observed during the 32month observation. Conclusion Transplantation of mobilized autolo2, l; p" s5 w' d
gous PBSC might be a simple , safe , and effective method for the treatment of ASO.! Z5 G. L5 k* I0 M! r) K1 P4 Y
【Key words】 Hematopoietic stem cell transplantation ; Transplantation , autologous ; Arteriosclerosis ob2
9 c8 ~8 K4 @7 V6 i0 hliterans% Q2 d' X8 J; F" D3 |( c, }/ Y# Y3 ^
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发表于 2009-3-2 11:49
