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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$ f% E" B! p4 ~+ b黄平平　李尚珠　韩明哲　肖志坚　杨仁池　邱录贵　钱冠清& z& S- h' ^5 V: z" y" d
付仁敏　郑亚丽　刘春华　徐秀强　李君凡　韩忠朝
: A, Q) x, s3 T4 |　　【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( D: `6 d% G$ u" j. L
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
& N5 d/ B9 s1 x4 {: E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
8 f0 |6 X; g% M2 A6 m4 V( |+ f3 P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! u/ }: g! \/ H! p6 T
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; c' c6 K: }% m6 ~; F. j' Y  [* T
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. H# o( |1 }) _0 c. h
±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 ,$ N9 r7 L8 i/ w4 ~: F2 x5 g
(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
9 r. t; G) P9 g2 i) k( d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 L* }% x9 |4 y) E, j. v法简单、安全、有效,值得推广应用和深入研究。9 g! V- ^8 E$ x+ H5 x$ Z" g8 L
　　【关键词】　造血干细胞移植; 　移植,自体; 　动脉硬化,闭塞性4 e8 I3 M+ K! \* f
Transplantation of autologous peripheral blood stem cells for the treatment of lower limb arteriosclerosis ob2
8 ~4 v# d7 V1 H$ _; Fliterans 　HUANG Ping2ping ,LI Shang2zhu , HAN Ming2zhe , XIAO Zhi2jian , YANG Ren2chi ,QIU Lu2gui , QIAN; B$ x0 \: s% X% O
Guan2qing , FU Ren2min , ZHENG Ya2li , LIU Chun2hua , XU Xiu2qiang , LI Jun2fan , HAN Zhong2chao. Insti2
5 A1 C% c' z3 D/ Ftute of Hematology &Blood Diseases Hospital ,National Research Center of Stem Cell Engineering & Technology , Chi2
4 a! D* E3 N" X+ L$ |/ Snese Academy of Medical Sciences & Peking Union Medical College , Tianjin 　300020 , China6 E+ _& d" a* X
Corresponding author : HAN Zhong2chao. O7 e/ r" ?/ @
【Abstract】　Objective 　To evaluate the clinical efficacy of mobilized autologous peripheral blood stem cells
; C. `! D" N+ i' ]' @& h(PBSC) transplantation in a 48 years old patient with lower limb arteriosclerosis obliterans (ASO) . Methods 　rhG2& J: L4 g2 s5 R/ k' ^9 Q+ a
CSF 600μgPd for 5 days to mobilize stem cells. On the fifth day , PBSC were collected with a Version 4 blood2cells
# A6 d! Q/ e+ P* J) C5 L0 A5 _. sseparator. Three hours late , the PBSC were intramuscularly injected into the ischemic areas of the two lower limbs  q, d& ?: n# j
(3 ×109 cells per limb) . The clinical and laboratory findings were monitored every week for 3 months. Forty2four: J- d; G; x4 }, }
days after the implantation , left lower limb with severe ASO was given an additional implantation of the same number
( b" F8 t+ M9 {' _of cells as the first time. Results 　The peripheral blood CD34
( t1 u! b: c, Z6 W8 i4 Q( m# ~+ cells were increased from 0. 18 % to 0. 75 % after 5
8 j! X4 L1 D0 z9 ydays of rhG2CSF mobilization. Three months after the first stem cell transplantation , severe pain lameness , local
# S/ J& o) a7 p5 p" ^cool2feeling and ulcer were improved , and ABI increased from 0. 49 ,0. 69 to 0. 50 ,0. 85 , the amplitude of blood+ T! Z0 @9 L8 |6 G: }( R
flow and laser Doppler blood perfusion were also significantly improved( P < 0. 01) . At the same time , digital sub28 x5 {, Q/ Q% T) g) W3 C& \
traction angiographic scores for new collateral vessel formation were showed as + 3(rich) . No related complication
$ Q4 u- G" Y9 _! {4 l8 ]1 Tor adverse effect were observed during the 32month observation. Conclusion 　Transplantation of mobilized autolo27 D2 Y& p0 p# V, Q% E: K
gous PBSC might be a simple , safe , and effective method for the treatment of ASO.
! p  @7 ?) h1 e* {& ^【Key words】　Hematopoietic stem cell transplantation ; 　Transplantation , autologous ; 　Arteriosclerosis ob2
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才子张

还不错

ligangcangxb

有些价值

sdufo

很好，参考一下，谢谢您正在看的文章来自干细胞之家

uuyuq

学习

huangjintang056

1# 月光梦
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三月

不错，谢谢

zhumd

谢谢

yonglinA

好东西

traveller304

学习一下