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目的比较自体干细胞治疗(autologous stem cell therapy,ASCT)和经皮腔内血管成形术(percutaneous transluminal angioplasty,PTA)治疗缺血性糖尿病足病(ischemia diabetic foot,IDF)的效果。方法 84例IDF患者纳入研究,28例患者进行PTA治疗,32例患者接受自体干细胞治疗(外周血干细胞治疗13例,骨髓干细胞治疗19例),24例无法或不愿接受PTA或ASCT治疗的患者作为对照组,随访12月,对截肢率、经皮氧分压(Tc PO2)和伤口愈合进行了评估。结果随访6月和12月后ASCT和PTA组的截肢率显著低于对照组(P=0.002和P=0.003),而ASCT和PTA组之间没有显著差异。对于Tc PO2的改善,ASCT和PTA组之间也没有显著差异(二者均与基线相比P<0.05),而对照组的Tc PO2在随访期间无明显升高。我们观察到ASCT组的溃疡愈合率高于PTA组和对照组(81.2%对55.2%与21.3%,P<0.05)。结论本研究表明ASCT和PTA治疗均能显著降低IDF患者的截肢率,ASCT治疗对于溃疡愈合有更显著的疗效。本研究结果支持ASCT是一种潜在的极有前途的治疗IDF的方法。
Objective To compare the effects of autologous stem cell therapy (ASCT) and percutaneous transluminal angioplasty (PTA) on ischemic diabetic foot disease (IDF). Methods Eighty-four patients with IDF were included in the study, 28 patients were treated with PTA, 32 patients received autologous stem cell therapy (13 cases of peripheral blood stem cells and 19 cases of bone marrow stem cells), and 24 patients who were unwilling or unwilling to receive PTA or ASCT As a control group, the amputation rate, Tc PO2 and wound healing were followed up for 12 months. Results The amputation rates of ASCT and PTA group were significantly lower than those of the control group (P = 0.002 and P = 0.003) after follow-up at June and December, but there was no significant difference between ASCT and PTA groups. There was also no significant difference between the ASCT and PTA groups for improvement of Tc PO2 (both P <0.05 vs. baseline), while the control group had no significant increase in Tc PO2 during follow-up. We observed that the healing rate of ulcer in ASCT group was higher than that in PTA group and control group (81.2% vs 55.2% vs 21.3%, P <0.05). Conclusion This study shows that ASCT and PTA treatment can significantly reduce the amputation rate in IDF patients, ASCT treatment for ulcer healing has a more significant effect. The results of this study support that ASCT is a potentially promising method of treating IDF.