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为评价自体外周血干细胞移植对糖尿病足的临床疗效及对血管内皮功能的影响,选取河北医科大学第四医院内分泌科收治的已确诊2型糖尿病伴糖尿病足患者36例,同期选择12例与患者性别、年龄相匹配的健康体检者作为正常对照组。患者组皮下注射重组人粒细胞集落刺激因子进行自体外周血干细胞动员,3~7d后采集单个核细胞,配成干细胞混悬液,2h内行双下肢多点肌肉注射,根据血管造影结果选择注射范围。与移植前比较,移植后1周患者双下肢冷感、麻木、疼痛明显好转;移植后1个月溃疡基本愈合;移植后3个月踝肱压指数明显升高(P<0.05),数字减影血管造影示新生侧支血管数量明显增多,内皮依赖性血管舒张功能明显好转(t=8.28,P<0.01),但仍低于正常对照组(t=3.08,P<0.01),未出现严重并发症和不良反应。提示动员后的自体外周血干细胞移植治疗糖尿病足方法简单,安全有效,且可改善血管内皮功能。
To evaluate the clinical efficacy of autologous peripheral blood stem cell transplantation on diabetic foot and its effect on vascular endothelial function, 36 patients with confirmed type 2 diabetes mellitus and diabetic foot admitted to Department of Endocrinology, the Fourth Hospital of Hebei Medical University were selected. Twelve patients Sex, age matched healthy physical examination as a normal control group. The patients were subcutaneously injected with recombinant human granulocyte colony-stimulating factor to mobilize autologous peripheral blood stem cells. Mononuclear cells were harvested after 3 ~ 7 days, mixed with suspension of stem cells, intramuscular injection of multi-point lower extremities within 2 hours, the injection range according to angiography . Compared with those before transplantation, the temperature and numbness of both lower extremities were significantly improved after 1 week of transplantation, and the ulcer basically healed 1 month after transplantation. The ankle-brachial pressure index was significantly increased 3 months after transplantation (P <0.05) Angiography showed that the number of collateral vessels was significantly increased and endothelium-dependent vasodilation was significantly improved (t = 8.28, P <0.01), but still lower than that of the normal control group (t = 3.08, P <0.01) Complications and adverse reactions. Prompted mobilization of autologous peripheral blood stem cell transplantation for diabetic foot treatment method is simple, safe and effective, and can improve endothelial function.