自体骨髓干细胞移植治疗血栓闭塞性脉管炎：5年随访

摘要

背景：慢性缺血性疾病的长期疗效评估较短期疗效评估更为重要，关系患者远期生活质量及长期生存率。目的：分析自体骨髓干细胞移植治疗血栓闭塞性脉管炎的5年随访结果。方法：收集新疆医科大学第一附属医院血管甲状腺外科自2007年8月至2010年1月行自体骨髓干细胞移植的血栓闭塞性脉管炎患者43例。移植后1，2，3，4，5年电话定期随访疼痛、冷感、间歇性跛行距离，并观察患肢溃疡的变化情况。移植后1年复查患肢静脉血氧分压和血氧饱和度。结果与结论：有完整随访资料的血栓闭塞性脉管炎患者38例进入结果分析。38例患者的疼痛、冷感、间歇性跛行情况较移植前明显好转，差异有显著性意义(Z值分别为-4.277、-5.086、-3.574，P <0.001)。移植后1-5年间相比，患者的疼痛、冷感情况差异无显著性意义(P >0.05)，间歇性跛行距离逐渐增加，差异有显著性意义(Z=43.898，P<0.001)。患肢静脉血氧分压和血氧饱和度移植前与移植后1年对比差异有显著性意义(t值分别为36.790、43.964，P值分别为0.040、0.037)。以上结果表明自体骨髓干细胞移植治疗血栓闭塞性脉管长期效果稳定。%BACKGROUND:The assessment for long-term efficacy of chronic ischemic disease is more important than the short-term efficacy assessment, which associates with patient’s long-term quality of life and long-term survival rate. OBJECTIVE:To observe the 5-year folow-up outcomes of autologous bone marrow stem cel transplantation for the treatment of thromboangitis obliterans. METHODS:This study enroled 43 patients of thromboangitis obliterans who underwent autologous bone marrow stem cel transplantation from August 2007 to January 2010 in the Department of Thyroid Vascular Surgery, the First Affiliated Hospital of Xinjiang Medical University. At 1, 2, 3, 4 and 5 years after transplantation, pain, cold sensation, and intermittent claudication distance were folowed up by telephone; changes in limb ulcers were observed. At 1 year after transplantation, venous oxygen partial pressure and oxygen saturation of limbs were reviewed. RESULTS AND CONCLUSION:A total of 38 thromboangitis obliterans patients with complete folow-up data were included in the final analysis. Compared to the preoperation, pain, cold sensation, and intermittent claudication significantly improved. The difference was statisticaly significant (Z values:-4.277,-5.086,-3.574, P < 0.001). Compared with 1-5 years after operation, pain and cold sensation had no statisticaly difference (P >0.05). Intermittent claudication distance had increased. Differences in terms of intermittent claudication distance was statisticaly significant (Z=43.898,P < 0.001). Significant differences in venous oxygen partial pressure and oxygen saturation were detected between preoperation and 1-year posttransplantation (tvalues: 36.790, 43.964,P values: 0.040, 0.037). Above results suggest that autologous bone marrow stem cel transplantation for thromboangitis obliterans obtained stable long-term outcomes.