自体骨髓干细胞移植治疗糖尿病足临床观察

摘要

[目的]观察自体骨髓干细胞移植治疗糖尿病足的临床疗效.[方法]2009年3月至2010年5月,应用自体骨髓干细胞移植治疗16例糖尿病足患者.手术首先抽取自体骨髓200～300 mL,从中分离出单个核细胞悬浊液约40 mL,行下肢缺血肌肉内局部注射.[结果]移植后大部分患者下肢疼痛、麻木、冷感、间歇性跛行均有不同程度缓解,足部皮温、ABI、经皮氧分压较前升高,动脉造影显示有新生侧枝血管形成,足部溃疡面缩小、甚至愈合,减少了截肢或降低了截肢平面.[结论]对于经内科保守治疗无效,不能行血管搭桥术及介入治疗的糖尿病足患者,自体骨髓干细胞移植治疗糖尿病足是一种有效的方法.%[Objective]To observe the clinical efficacy of autologous transplantation of bone marrow stem cells in the treatment of diabetic feet. [Methods] Sixteen patients with diabetic feet were treated by autologous transplantation of bone-marrow stem cells from Mar. 2009 to May 2010. After aspiration of 200～300 mL of bone marrow, about 40ml mononuclear cell suspension were seperated and then injected into the skeletal muscles of the ischemic leg. [Results] The complications including pain of lower limbs, numbness, cold feeling and intermittent claudication in most patients after surgery were alleviated in this group in different extent.Skin temperature, ABI and TcPO2 were elevated. Angiography showed the neovascularization of collateral vessels, the decreasing or healing of feet ulcer and the reducing of amputation or the lowering of the level of amputation. [Conclusion] For the patients failed to expectant treatment in internal medicine and unfeasible to undergo vessel bypass or interventional therapy, autologous transplantation of bone marrow stem cells is a effective method for treating diabetic feet.