干细胞重建糖尿病足缺血态组织血流

摘要

Objective To investigate the clinical effect of the transplantation of autologous peripheral blood stem cells (TPBSC) for blood flow remodeling in isehemic tissue of diabetic foot. Methods 42 patients with diabetic foot from Yunnan Provincial Center of Vascular Surgery were enrolled in this study. 42 cases underwent the transplantation of autologous peripheral blood stem from march 2005 to December 2008. The multifunction monitoring device, dopplor ultrasound monitoring device, percutaneous oxygen partial pressure moni- taring device (TcPO2) and digital subtractionangiography (DSA) were used to assess the effect degree of limbs regional blood flow from cutaneous covering, blood vessel and blood between preoperative and post-operative, the follow-up time was one year. Results The effect indexes of limbs regional blood flow of the case by transplantation of autologous peripheral blood stem cells were as follows: skin temperature index (STI) was (1.6 ±0.3) , percutaneous oxygen partial pressure monitoring device (TcPO2) was (37.6± 9.5) mmHg, ankle-brachium index (ABI) was (0.9 ± 0.2), photoplethysmography index (PPGI) was (0.8 ±0.1), saturation of blood oxygen (SaO2) was (79.4 ± 20.4) percent, digital subtraction angiography score (DSAS) was (1.3 ±0.2), distance of intermittence limp was (46.2 ± 10.6) meters. Conclusion Transplantation of autologous peripheral blood stem cells can improve the blood flow remodeling in isehemic tissue of diabetic foot.%目的 探讨自体外周血干细胞移植改善糖尿病足缺血态组织血流的临床效应.方法 下肢动脉缺血性疾病糖尿病足42例,均接受自体外周血干细胞移植术治疗,术后随访1a.术前术后观察均采用多功能监测仪、多谱勒检测仪、经皮氧分压监测仪及数字减影血管造影仪等于皮肤、血管及血液3种组织层面测算肢体局部血流量变效应程度.结果 自体干细胞移植术后患者肢体局部血流量变效应指标皮温指数(1.6±0.3),经皮氧分压(37.6± 9.5) mmHg,踝肱指数(0.9±0.2),光电容积微血流态指数(0.8±0.1),血氧饱和度(79.4±20.4)％,数字减影血管造影评分(1.3±0.2),间歇性跛行距离延长(46.2±10.6)m.结论 自体外周血干细胞可促进糖尿病足缺血态组织部分血管新生和改善下肢的缺血症状.