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目的观察自体外周血干细胞(PBSC)和骨髓干细胞(BMSC)移植在下肢缺血性疾病患者中血管新生和改善缺血状态方面的疗效。方法2004年9月至2006年10月对解放军第463医院细胞治疗中心的170例自愿接受自体干细胞移植的下肢缺血性血管疾病患者随机分为PBSC移植组(94例)和BMSC移植组(76例)。第1,4,12,24周对移植前后临床症状主观指标和仪器检测客观指标结果进行综合评估,比较两组患者血管新生及下肢缺血改善情况。结果PBSC组单个核细胞(MNC)、CD34+、CD133+细胞总数明显多于BMSC组(P<0.01);干细胞移植前后疼痛、冷感、行走间距、溃疡、坏疽等临床症状对照研究表明,PBSC组缺血症状改善较BM-SC组出现早,症状缓解程度较BMSC组更明显,但两组间差异无显著性意义(P(0.05);两组患者移植前后的踝肱指数(ABI)、经皮氧分压、足底深感觉、皮温仪结果比较差异无显著性意义。结论自体PBSC和BMSC移植技术在下肢缺血性疾病治疗中均可建立新生血管,有效改善下肢缺血状态,治疗缺血性下肢血管疾病各有其不可替代的优势,可根据患者具体情况选择干细胞来源。
Objective To observe the effects of autologous peripheral blood stem cells (PBSC) and bone marrow stem cells (BMSCs) transplanting on angiogenesis and improvement of ischemic status in patients with lower extremity ischemic disease. Methods From September 2004 to October 2006, 170 patients with autologous stem cell transplantation-induced ischemic vascular disease in the 463 Hospital of PLA, were randomly divided into two groups: PBSC transplantation group (94 cases) and BMSC transplantation group (76 cases) example). The subjective indexes of clinical symptoms before and after transplantation and the objective indexes of the instruments were evaluated comprehensively on the 1st, 4th, 12th and 24th weeks. The improvement of angiogenesis and lower limb ischemia were compared between the two groups. Results Compared with BMSC group, the number of MNC, CD34 + and CD133 + cells in PBSC group was significantly higher than that in BMSC group (P <0.01). The control group showed no significant difference in the clinical symptoms such as pain, cold sensation, walking distance, ulcer and gangrene before and after stem cell transplantation The improvement of blood symptoms was earlier than that of BM-SC group and the degree of remission was more obvious than that of BMSC group (P <0.05). The ankle-brachial index (ABI) of both groups before and after transplantation Oxygen partial pressure, plantar deep feeling, skin temperature instrument results were no significant difference.Conclusion Autologous PBSC and BMSC transplantation can establish new blood vessels in the treatment of lower limb ischemic disease, effectively improve the lower limb ischemic state, the lack of treatment Bloody lower extremity vascular diseases have their own irreplaceable advantages, according to the specific circumstances of patients choose stem cell sources.