自体外周血干细胞移植治疗下肢动脉硬化性闭塞症

月光梦

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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
5 W# e3 _4 d0 k7 C5 U6 m0 l+ G付仁敏　郑亚丽　刘春华　徐秀强　李君凡　韩忠朝3 M9 l$ ?3 h$ x! G
　　【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
1 J+ j( k+ \  `# [5 W2 b1 p$ ?# G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
* p/ {- [6 s5 S! i  l, x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; `' e6 o" ]# |" o: T& Y
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
$ z6 V$ n: y3 b# v, C+ g. {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
6 ]) {+ {2 W+ f3 |: S$ k1 W6 R% Y* |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. 909 r  ^, {5 a' k$ W6 U2 _# {4 {
±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 ,9 w1 r+ R, G& l, v+ ?) Q7 ?
(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
- j8 y& k6 h! ?: u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1 I  M4 t3 n8 s0 e4 x) A
法简单、安全、有效,值得推广应用和深入研究。1 n0 ]7 y' ^) b! z7 ~* K
　　【关键词】　造血干细胞移植; 　移植,自体; 　动脉硬化,闭塞性
1 B  d% x) @# x- E6 w; jTransplantation of autologous peripheral blood stem cells for the treatment of lower limb arteriosclerosis ob2  @/ \! p; V  Q( {  i) V
literans 　HUANG Ping2ping ,LI Shang2zhu , HAN Ming2zhe , XIAO Zhi2jian , YANG Ren2chi ,QIU Lu2gui , QIAN
. G( @, Q0 D4 x0 gGuan2qing , FU Ren2min , ZHENG Ya2li , LIU Chun2hua , XU Xiu2qiang , LI Jun2fan , HAN Zhong2chao. Insti2
" i# P8 c9 z2 p. U- I, j' D/ g0 |+ I  Ztute of Hematology &Blood Diseases Hospital ,National Research Center of Stem Cell Engineering & Technology , Chi2+ Q2 W- P* y* ]
nese Academy of Medical Sciences & Peking Union Medical College , Tianjin 　300020 , China. Q1 D1 F7 d; C$ v; `% d2 v
Corresponding author : HAN Zhong2chao
& F: [! A9 I  a, D【Abstract】　Objective 　To evaluate the clinical efficacy of mobilized autologous peripheral blood stem cells5 k* c8 n# y: P* X( B; P
(PBSC) transplantation in a 48 years old patient with lower limb arteriosclerosis obliterans (ASO) . Methods 　rhG2
2 }# }# w% M5 k; i9 e* YCSF 600μgPd for 5 days to mobilize stem cells. On the fifth day , PBSC were collected with a Version 4 blood2cells5 q9 e' Z" Q) l3 W. [4 G
separator. Three hours late , the PBSC were intramuscularly injected into the ischemic areas of the two lower limbs# c8 o+ u* l# _( V2 z. K6 G+ c
(3 ×109 cells per limb) . The clinical and laboratory findings were monitored every week for 3 months. Forty2four7 t1 d- C" p0 c  e
days after the implantation , left lower limb with severe ASO was given an additional implantation of the same number2 y  o+ n# o3 H% }( [
of cells as the first time. Results 　The peripheral blood CD34+ R2 f8 P) A2 W$ T- m" Y# B- Y6 |
+ cells were increased from 0. 18 % to 0. 75 % after 5/ w6 [* C3 P; h8 W7 b/ [# T( u1 d
days of rhG2CSF mobilization. Three months after the first stem cell transplantation , severe pain lameness , local
/ F8 P  J% k: \. |# y# y7 H7 J, Q/ Ucool2feeling and ulcer were improved , and ABI increased from 0. 49 ,0. 69 to 0. 50 ,0. 85 , the amplitude of blood- X  [# L) G2 S# }
flow and laser Doppler blood perfusion were also significantly improved( P < 0. 01) . At the same time , digital sub29 s5 f; R/ g- y- J
traction angiographic scores for new collateral vessel formation were showed as + 3(rich) . No related complication
; b5 H, i" y$ |$ Eor adverse effect were observed during the 32month observation. Conclusion 　Transplantation of mobilized autolo2
& r' f! q8 H$ ?: D+ u3 t8 c) cgous PBSC might be a simple , safe , and effective method for the treatment of ASO.  j* `+ n9 {4 {4 X
【Key words】　Hematopoietic stem cell transplantation ; 　Transplantation , autologous ; 　Arteriosclerosis ob2
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才子张

还不错

ligangcangxb

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sdufo

很好，参考一下，谢谢您正在看的文章来自干细胞之家

uuyuq

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huangjintang056

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三月

不错，谢谢

zhumd

谢谢

yonglinA

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traveller304

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