联合介入及自体外周血干细胞移植治疗下肢动脉缺血性疾病

张瑞鹏; 王辉; 戴毅; 张鸿; 李伟; 王小军; 高增战

联合介入及自体外周血干细胞移植治疗下肢动脉缺血性疾病

1. 陕西省人民医院血管外科
2. 陕西省人民医院普外二科

基金项目:

基金：陕西省科技攻关资助项目 (2014K11-02-01-08);

计量
- 文章访问数: 3149
- HTML全文浏览量: 1161
- PDF下载量: 48
- 被引次数: 0
出版历程
- 收稿日期: 2018-02-19

Clinical Effect of Autologous Peripheral Blood Stem Cell Transplantation Combined with Interventional Therapy in Treatment of Chronic Lower Limb Ischemia

Funds:

基金：陕西省科技攻关资助项目 (2014K11-02-01-08);

摘要

摘要: 目的观察联合经皮腔内血管成形术 (PTA) 及自体外周血干细胞移植 (ABSCT) 治疗下肢动脉缺血性疾病可行性和近期效果.方法研究共入组48例下肢动脉缺血性疾病患者, 依自愿原则分组, 仅采用PTA治疗的19例患者为PTA组, 单纯ABSCT组10例, PTA与ABSCT联合治疗的19例患者为联合治疗组.常规治疗方案3组相同, 对3组患者的疼痛感、冷感、间歇跛行、踝肱指数 (ABI) 、侧支血管生成数量等方面的指标进行比较, 从而判断3组患者的疗效差异.结果在疼痛感、冷感、间歇跛行3方面3组患者均明显降低, 差异有统计学意义 (P<0.05) , ABI评分与侧支血管生成数评分方面, 3组均升高, 差异有统计学意义 (P<0.05) .与PTA及ABSCT组比较, 联合治疗组在疼痛感、冷感、间歇跛行方面、ABI评分与侧支血管生成数评分改善更为明显 (P<0.05) .联合治疗组的有效率是89.5%, PTA组的有效率是78.9%, ABSCT组的有效率是60.0%, 联合治疗组效果显著优于PTA组和ABSCT组 (P<0.05) .结论 PTA联合ABSCT治疗下肢动脉缺血性疾病安全、有效, 疗效优于单纯PTA术及单纯ABSCT移植治疗.
- 下肢动脉缺血性疾病 /
- 干细胞移植 /
- 介入治疗
Abstract: Objective To investigate the clinical effect of percutaneous transluminal angioplasty (PTA) combined with autologous peripheral blood stem cell transplantation (ABSCT) in treating chronic lower limb ischemia.Me thods A total of 48 patients with chronic lower limb ischemia were voluntarily allocated into 3 groups: 19 patients treated with ABSCT combined with PTA, named as combined treatment group; 10 patients treated with ABSCT alone, named as single ABSCT group; and 19 patients treated with PTA alone, named as single PTA group. Patients in 3 groups received conventional therapy. Limb pain, cold feeling, intermittent claudication, ankle brachial index (ABI) and the number of collateral vessel formation of patients in 3 groups were assessed before and after treatment. Comparison of clinical effects was performed in 3 groups.Re s ults Limb pain scores, cold feeling scores and intermittent claudication scores of the patients in 3 groups significantly decreased after treatment (P <0.05) . ABI score and the number of collateral vessel formation significantly increased (P<0.05) . The combined treatment group showed obvious improvement in all the measured assessmentindicators (P<0.05) . The total effective rate of combined treatment group was 89.5% while that in PTA group and ABSCT group were 78.9% and 60.0%, respectively. The total effective rate in combined treatment group was higher than that in both PTA group and ABSCT group (P <0.05) . Conclus ion When treating chronic lower limb ischemia, combination use of PTA and transplantation of ABSCT is safe and effective, and its treatment effect is superior to single PTA as well as single ABSCT.
- Chronic lower limb ischemia /
- ABSCT /
- Percutaneous transluminal angioplasty

HTML全文

参考文献(17)

[1]	[1]SAKAKI S, TAKAHASHI T, MATSUMOTO J, et al.Characteristics of physical activity in patients with critical limb ischemia[J].J Phys Ther Sci, 2016, 28 (12) :3454-3457.
[2]	[2]DOHMEN A, EDER S, EURINGER W, et al.Chronic critical limb ischemia[J].Dtsch Arztebl Int, 2012, 9 (6) :95-101.
[3]	[3]MOAZZAMI K, MAJDZADEH R, NEDJAT S.Local intramuscular transplantation of autologous mononuclear cells for critical lower limb ischaemia[J].Cochrane Database Syst Rev, 2014, 19 (12) :CD008347.
[4]舒畅, 何昊.下肢缺血性疾病的诊治进展[J].中国普通外科杂志, 2008, 17 (6) :523-527.
[5]	[5]ASAHARA T, MUROHARA T, SULLIVAN A, et al.Isolation of putative progenitor endothelial cells for angiogenesis[J].Science, 1997, 275 (5302) :964-967.
[6]	[6]HAMANO K, NISHIDA M, HIRATA K, et al.Local implantation of autologous bone marrow cells for therapeutic angiogenesis in patients with ischeminc heart disease;clinical trial and preliminary results[J].Jpn Circ J, 2001, 65 (9) :845-847.
[7]	[7]THEJ C, RAMADASSE B, WALVEKAR A, et al.Development of a surrogate potency assay to determine the angiogenic activity of Stempeucel (R) , a pooled, ex-vivo expanded, allogeneic human bone marrow mesenchymal stromal cell product[J].Stem Cell Res Ther, 2017, 8 (1) :47.
[8]李茂, 黄文.自体干细胞移植治疗严重下肢缺血[J].中国组织工程研究, 2013, 17 (49) :8602-8607.
[9]孙英伦, 杨镛, 马振桓, 等.自体外周血干细胞移植联合置管溶栓术治疗TAO患者血流重建并降低截肢平面[J].昆明医科大学学报, 2017, 38 (03) :59-63.
[10]叶丹, 闫波.自体骨髓干细胞移植治疗下肢缺血性疾病的临床研究[J].宁夏医科大学学报, 2016, 38 (12) :1436-1438.
[11]倪冷, 刘昌伟, 李拥军, 等.主髂动脉闭塞腔内治疗技巧及疗效[J].血管与腔内血管外科杂志, 2015, 1 (1) :32-35.
[12]赵杰, 杨立民, 张震, 等.介入溶栓与动脉取栓术治疗急性下肢动脉缺血疗效对比[J].昆明医科大学学报, 2015, 36 (11) :133-135.
[13]	[13]MWIPATAYI B P, HOCKINGS A, HOFMANN M, et al.Balloon angioplasty compared with stenting for treatment of femoropopliteal occlusive disease:A meta-analysis[J].J Vasc Surg, 2008, 47 (2) :461-469.
[14]	[14]XIAO L, HUANG DS, TONG J J, et al.Efficacy of endoluminal interventional therapy in diabetic peripheral arterial occlusive disease:a retrospective trial[J].Cardiovasc Diabetol, 2012, 11 (1) :1-17.
[15]	[15]PIAGGESI A, ABBRUZZESE L, MATTALIANO C, et al.Sulodexide as adjunctive therapy in diabetic foot patients with critical limb ischemia treated with percutaneous transluminal angioplasty[J].Int J Low Extrem Wounds, 2014, 13 (2) :103-109.
[16]	[16]LAWALL H, BRAMLAGE P, AMANN B.Treatment of peripheral arterial disease using stem and progenitor cell therapy[J].J Vasc Surg, 2011, 53 (2) :445-453.
[17]	[17]DASH SN, DASH NR, GURU B, et al.Towards reaching the target:clinical application of mesenchymal stem cells for diabetic foot ulcers[J].Rejuvenation Res, 2014, 17 (1) :40-53.

相关文章(20)

[1]	郭玺, 汤晓青, 王洁, 万焱, 徐斌, 罗煜. 早期介入姑息治疗对肝炎相关性肝癌患者疼痛、焦虑影响分析, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20220813
[2]	袁伟, 孟明耀, 李欣欣, 熊晶晶, 李檬, 曹佳, 刘梅, 侯宗柳, 黄永坤. 内毒素的量效和时效对人脐带间充质干细胞增殖的影响, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20220928
[3]	常国楫, 黄瑛, 张燕玲, 何花, 徐俊, 李杨. Ommaya囊与腰大池介入对结核性脑膜脑炎并脑积水的疗效对比, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20210423
[4]	刘新志, 赵恒, 罗谊, 许敏华, 闵晓黎. DSA诊断及介入治疗缺血性脑卒中患者颈部血管狭窄的疗效及生存质量, 昆明医科大学学报.
[5]	侯晓梅, 祁文瑾. 中期妊娠胎盘前置状态出血引产行介入治疗的护理总结, 昆明医科大学学报.
[6]	黄松霞. 循证护理对冠心病介入治疗术后患者并发症发生率及舒适度的影响, 昆明医科大学学报.
[7]	童玉云. 靶血管超选择性栓塞治疗难治性大咯血的临床应用, 昆明医科大学学报.
[8]	王世平. 胆道支架介入治疗恶性梗阻性黄疸的临床应用, 昆明医科大学学报.
[9]	章体玲. 小儿先天性心脏病介入治疗麻醉处理临床观察, 昆明医科大学学报.
[10]	赖碁. 两种股动脉血管闭合器的临床应用疗效, 昆明医科大学学报.
[11]	王世平. 动脉源性大出血介入治疗的临床应用, 昆明医科大学学报.
[12]	戴海龙. 多孔型房间隔缺损的介入治疗, 昆明医科大学学报.
[13]	鲁一兵. 继发孔型房缺封堵术前后心律失常的变化, 昆明医科大学学报.
[14]	罗静. 剖宫产致产后出血经介入治疗失败后行子宫全切术9例报道, 昆明医科大学学报.
[15]	刘海莉. 子宫动脉甲氨蝶呤灌注栓塞治疗子宫腺肌病临床研究, 昆明医科大学学报.
[16]	文娇. 胸主动脉夹层瘤介入治疗的临床疗效评价, 昆明医科大学学报.
[17]	黄明. 介入栓塞治疗嗜铬细胞瘤临床疗效的初步探讨, 昆明医科大学学报.
[18]	郭曦. 平阳霉素加碘化油经肝动脉栓塞治疗肝血管瘤42例临床体会, 昆明医科大学学报.
[19]	王世平. 肝动脉栓塞治疗肝血管瘤病人51例疗效分析, 昆明医科大学学报.
[20]	王启贤. 经导管植入人造血管覆盖支架治疗降主动脉夹层11例, 昆明医科大学学报.