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
! Z7 x. A5 d& w6 p付仁敏　郑亚丽　刘春华　徐秀强　李君凡　韩忠朝% s/ y6 w) `) C9 B# n3 W: c
　　【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7 _! z% w2 B  x1 S) T5 i8 K9 T+ f
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$ g: Z! \, [0 s) M% K0 N& _
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
' k3 W, m  c- k' F! ^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1 v3 G5 M; `. R' q. h
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
# n; _( n! Z" v% d0 r+ B1 D+ ]" r. L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
% C3 g" o- |. C, \8 b+ `" T1 [±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 ,
! a6 v7 d0 r1 z) |$ u% R(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3 k" E; H* h1 d) U7 e1 ~2 B
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
. }! Q( o2 ^) ?" e法简单、安全、有效,值得推广应用和深入研究。5 ^' l; i( i( H/ C; n
　　【关键词】　造血干细胞移植; 　移植,自体; 　动脉硬化,闭塞性- A' k& s5 s" B5 V1 k' v% _
Transplantation of autologous peripheral blood stem cells for the treatment of lower limb arteriosclerosis ob2: r/ O* |3 ~0 _( ~, D
literans 　HUANG Ping2ping ,LI Shang2zhu , HAN Ming2zhe , XIAO Zhi2jian , YANG Ren2chi ,QIU Lu2gui , QIAN! T2 v, r6 U. D: u& I9 \% ]# V
Guan2qing , FU Ren2min , ZHENG Ya2li , LIU Chun2hua , XU Xiu2qiang , LI Jun2fan , HAN Zhong2chao. Insti2  b) W8 |# \) w( C: L/ o
tute of Hematology &Blood Diseases Hospital ,National Research Center of Stem Cell Engineering & Technology , Chi2* f$ N! F1 ~- [$ T% y9 r
nese Academy of Medical Sciences & Peking Union Medical College , Tianjin 　300020 , China6 F8 X% W/ n' i
Corresponding author : HAN Zhong2chao
) Z4 e- z" Z4 j* b$ `5 d【Abstract】　Objective 　To evaluate the clinical efficacy of mobilized autologous peripheral blood stem cells
# S0 X( W% i; v. M( [) x( ~. n8 C(PBSC) transplantation in a 48 years old patient with lower limb arteriosclerosis obliterans (ASO) . Methods 　rhG2* Z' H+ ^0 d6 v! T
CSF 600μgPd for 5 days to mobilize stem cells. On the fifth day , PBSC were collected with a Version 4 blood2cells% s( Y+ s5 W: g
separator. Three hours late , the PBSC were intramuscularly injected into the ischemic areas of the two lower limbs
6 T0 m' A9 M/ W1 l1 V(3 ×109 cells per limb) . The clinical and laboratory findings were monitored every week for 3 months. Forty2four
3 V2 }2 U1 l. X, S8 cdays after the implantation , left lower limb with severe ASO was given an additional implantation of the same number5 H3 D8 T9 i) h' b
of cells as the first time. Results 　The peripheral blood CD34% l$ r- ~6 |' o: d
+ cells were increased from 0. 18 % to 0. 75 % after 5
1 \, J2 Q. x0 ?% C. g6 n0 A; d5 gdays of rhG2CSF mobilization. Three months after the first stem cell transplantation , severe pain lameness , local$ X4 b  F, y9 i+ i
cool2feeling and ulcer were improved , and ABI increased from 0. 49 ,0. 69 to 0. 50 ,0. 85 , the amplitude of blood
! l8 i8 m% j- D6 ~! Z9 Cflow and laser Doppler blood perfusion were also significantly improved( P < 0. 01) . At the same time , digital sub29 K$ o" n, W6 U3 b
traction angiographic scores for new collateral vessel formation were showed as + 3(rich) . No related complication
! \6 U, g! p- o$ N/ K1 W1 {or adverse effect were observed during the 32month observation. Conclusion 　Transplantation of mobilized autolo27 J6 Z- v2 E1 @1 s! [, I& G- X* J
gous PBSC might be a simple , safe , and effective method for the treatment of ASO.
- {0 [( W; Z; P# D【Key words】　Hematopoietic stem cell transplantation ; 　Transplantation , autologous ; 　Arteriosclerosis ob2
+ {% Z. g* d. B" o8 Oliterans! k: O$ b0 O1 M8 s- h& C* z8 f% Z1 V

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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

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zhumd

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yonglinA

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traveller304

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