脐血干细胞移植2型糖尿病下肢血管病变患者内皮依赖性血管舒张的变化

摘要

背景：研究表明，干细胞在一定诱导条件下可分化成为血管性内皮细胞，促进局部血管再生，生成新的毛细血管网，建立丰富的侧支循环，以达到改善和治疗下肢缺血的目的。　　目的：观察脐血干细胞对2型糖尿病合并血管病变患者内皮依赖性血管舒张功能的影响。　　方法：100例2型糖尿病下肢血管病变患者分为两组，试验组60例，对照组40例，试验组静脉输注脐血干细胞，对照组输注生理盐水，4周后比较两组基础指标及内皮依赖性血管舒张功能。　　结果与结论：试验组治疗后空腹血糖、餐后2 h血糖、糖化血红蛋白、胆固醇、三酰甘油水平较治疗前均明显下降(P <0.05)，空腹胰岛素、餐后2 h胰岛素、血管内皮舒张功能较治疗前均明显升高(P <0.05)。对照组空腹血糖、餐后2 h血糖、糖化血红蛋白、胆固醇、三酰甘油、血管内皮舒张功能治疗前后差异无显著性意义(P >0.05)。结果表明脐血干细胞移植可以改善2型糖尿病下肢血管病变患者的内皮功能，促进侧支循环，避免糖尿病足的发生。%BACKGROUND:Studies have shown that under certain conditions stem cels can be induced to differentiate into vascular endothelial cels, promoting local angiogenesis, generating the new capilary network, and enriching the colateral circulation, so as to improve lower limb ischemia. OBJECTIVE:To explore the effects of umbilical cord blood stem cel transplantation on endothelium-dependent vasodilation of type 2 diabetic patients with lower extremity vascular disease. METHODS:Totaly 100 type 2 diabetic patients with lower extremity vascular disease were enroled and divided into two groups: experimental group (n=60) and control group (n=40). The experimental group adopted the intravenous injection of umbilical cord blood stem cels, while the control group was subject to normal saline infusion. After 4 weeks, basic indexes and endothelium-dependent vasodilation were compared between two groups. RESULTS AND CONCLUSION:In the experimental group, fasting blood glucose, 2-hour postprandial blood glucose, glycosylated hemoglobin, cholesterol, triglyceride levels were significantly reduced (P < 0.05), while fasting insulin, 2-hour postprandial insulin, vascular endothelial dilation function were significantly increased after treatment (P < 0.05). In the control group, there were no differences in fasting blood glucose, 2-hour postprandial blood glucose, glycosylated hemoglobin, cholesterol, triglyceride levels before and after treatment (P > 0.05). These findings indicate that umbilical cord blood stem cel transplantation can improve the endothelial function and promote the colateral circulation in type 2 diabetic patients with vascular lesions of lower extremities, thereby to avoid the occurrence of diabetic foot.