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2 a. ~# X2 l  a
付仁敏　郑亚丽　刘春华　徐秀强　李君凡　韩忠朝
9 B; c3 k- x9 }# m　　【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
% @- A. a2 r" R; m$ X( U: H9 W$ i3 u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$ f6 }5 ]0 y- P* ?
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: e- {# q; o* J9 l
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' o) u4 b7 N5 U! s) C
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
& d0 N  {( u3 [# l% \4 D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
# {' k3 w; m6 m2 G6 ]0 _) Q$ G±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 ,: b4 q( @1 L/ [) s8 z4 D1 T# \
(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
( ^  D7 S) H6 n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
8 M" p( E% \8 O. x$ B法简单、安全、有效,值得推广应用和深入研究。2 d0 ]# i& V* A! k/ _
　　【关键词】　造血干细胞移植; 　移植,自体; 　动脉硬化,闭塞性
! E2 V0 Q. U! u% Z6 d5 `  v$ e7 YTransplantation of autologous peripheral blood stem cells for the treatment of lower limb arteriosclerosis ob24 @' E% [4 [: v, o. E
literans 　HUANG Ping2ping ,LI Shang2zhu , HAN Ming2zhe , XIAO Zhi2jian , YANG Ren2chi ,QIU Lu2gui , QIAN1 y& ]" Y2 m1 V( Q
Guan2qing , FU Ren2min , ZHENG Ya2li , LIU Chun2hua , XU Xiu2qiang , LI Jun2fan , HAN Zhong2chao. Insti2
: q1 f* n* ~* N& f4 ~% Utute of Hematology &Blood Diseases Hospital ,National Research Center of Stem Cell Engineering & Technology , Chi2
; ?! T$ E1 D4 l( x: r4 lnese Academy of Medical Sciences & Peking Union Medical College , Tianjin 　300020 , China7 i& O' l! p: M% r5 B% P% C
Corresponding author : HAN Zhong2chao; t6 @0 M/ z% d
【Abstract】　Objective 　To evaluate the clinical efficacy of mobilized autologous peripheral blood stem cells# P9 T* N, j; F
(PBSC) transplantation in a 48 years old patient with lower limb arteriosclerosis obliterans (ASO) . Methods 　rhG2
! [8 D$ M3 ]* @5 N. uCSF 600μgPd for 5 days to mobilize stem cells. On the fifth day , PBSC were collected with a Version 4 blood2cells* I7 `9 z0 k% l9 U; v2 Y& O
separator. Three hours late , the PBSC were intramuscularly injected into the ischemic areas of the two lower limbs
# f0 P: x* r" @, |# x(3 ×109 cells per limb) . The clinical and laboratory findings were monitored every week for 3 months. Forty2four
7 C0 I9 l5 q- h. Mdays after the implantation , left lower limb with severe ASO was given an additional implantation of the same number6 a5 K) |2 D8 I$ S7 S. s0 A
of cells as the first time. Results 　The peripheral blood CD34
" |& Y( K+ Y* O. @+ cells were increased from 0. 18 % to 0. 75 % after 5  l& f) g; K9 F" t+ ~) U2 `% J7 E
days of rhG2CSF mobilization. Three months after the first stem cell transplantation , severe pain lameness , local
$ B. F" y& {3 b' ucool2feeling and ulcer were improved , and ABI increased from 0. 49 ,0. 69 to 0. 50 ,0. 85 , the amplitude of blood
" c- {$ ]) }5 eflow and laser Doppler blood perfusion were also significantly improved( P < 0. 01) . At the same time , digital sub2
/ g( t$ P% z. @" Q! `traction angiographic scores for new collateral vessel formation were showed as + 3(rich) . No related complication
# H+ \  [; Y: H* d7 B+ y* t! tor adverse effect were observed during the 32month observation. Conclusion 　Transplantation of mobilized autolo2
0 D; |  @: i1 p; x* C4 tgous PBSC might be a simple , safe , and effective method for the treatment of ASO.
6 O, Q. X+ L( S( C0 @$ T& b  L【Key words】　Hematopoietic stem cell transplantation ; 　Transplantation , autologous ; 　Arteriosclerosis ob2! t* S* D2 N$ V
literans
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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

1# 月光梦 * V, b5 [  p/ e  u& k* \

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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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