摘要
目的 探讨自体外周血干细胞CD34+细胞移植联合盐酸沙格雷酯口服对人体下肢血栓闭塞性脉管炎(TAO)血管重建与血供疗效的影响.方法 将262例TAO患者的262条下肢分为干细胞CD34+细胞移植联合盐酸沙格雷酯口服组100条下肢(A组)、干细胞CD34+细胞移植组91条下肢(B组)、盐酸沙格雷酯口服组71条下肢(C组).术前术后均采用多功能监测仪、多普勒检测仪、经皮氧分压监测仪、DSA等分别从皮肤、血管及血液三个层面测算肢体局部血流量变效应程度.结果 ⑴术后1个月A、B组小腿和足发绀、皮肤发凉及疼痛程度缓解情况较C组显著(P<0.05);⑵术后3个月,A、B组间歇性跛行距离、小腿和足部皮温改善情况较C组患者显著(F=7.01、F=7.04,P<0.05);⑶术后6个月截趾患者中A组10例、B组16例及C组31例;⑷术后1年A组患者中经皮氧分压自[(30.43±4.31)mmHg]增至[(37.21±9.01)mmHg](F=5.69,P<0.05)、踝肱指数自(0.32±0.23)增至(0.91±0.16)(F=6.71,P<0.05)、光电容积血流态指数自(0.22±0.04)增至(0.83±0.13)(F=5.69,P<0.05)、血氧饱和度自[(42.41±9.61)％]增至[(79.61±20.34)％](F=5.74,P<0.05)及数字减影血管造影评分自[(0.23±0.03)分]增至[(1.35±0.23)分](F=7.14,P<0.05),均较B组和C组显著升高(F=7.01、F=7.04、F=7.12、F=7.08、F=7.15,P<0.05).结论 外周血干细胞CD34+细胞移植联合盐酸沙格雷酯口服的治疗方法可显著改善人体下肢TAO血管再生及其血供.
Objective To investigate the effect of autologous peripheral blood stem cell transplanta-tion combined with CD34 + cells and oral sarpogrelate hydrochloride for the treatment of vascular reconstruc-tion and blood supply on the thromboangiitis obliterans. Methods Thromboangiitis obliterans ( TAO) of 262 patients with 262 lower limbs were divided into stem cells CD34 + cells transplantation combined with sarpogrelate hydrochloride group ( group A) with 100 lower limbs, CD34 + stem cell transplantation group ( group B) with 91 lower limbs, and sarpogrelate hydrochloride oral group ( group C) with 71 lower limbs. The degree of lower limb local blood flow variability were calculated at the three levels of skin, blood vessels and blood by preoperative and postoperative use of multi-function monitoring instrument, Doppler detector, transcutaneous oxygen pressure monitor, and digital subtraction angiography ( DSA) , respectively. Results⑴ The degree of shank, foot cyanosis, cool skin, and pain was relieved significantly in groups A and B than in group C for 1 month after the treatment (P<0. 05). ⑵Intermittent claudication distance, the skin temperature of the lower leg and foot to patients in the groups A and B than in group C, with a significant difference (F=7. 01, F=7. 04, P<0. 05) for 3 months after the treatment. ⑶ Among the patients with amputation, 10 cases were in group A, 16 cases in group B, and 31 cases in group C for 6 months after the treatment. ⑷ Transcutaneous oxygen pressure was increased from ( 30. 43 ± 4. 31 ) mmHg to ( 37. 21 ± 9. 01)mmHg (F=5. 69, P<0. 05), ankle brachial index from (0. 32 ±0. 23) to (0. 91 ± 0. 16) (F=6. 71, P<0. 05), the volume of blood flow index from the photoelectric (0. 22 ± 0. 04) to (0. 83 ± 0. 13 (F=5. 69, P<0. 05), oxygen saturation from (42. 41 ±9. 61)％ to (79. 61 ±20. 34)％ (F=5. 74, P<0. 05), and DSA score (0. 23 ± 0. 03) increased to (1. 35 ± 0. 23) (F=7. 14, P<0. 05), which was sig-nificantly higher than group B and group C ( F=7. 01, F=7. 04, F=7. 12, F=7. 08, F=7. 15, P<0. 05) for one year after treatment. Conclusions Treatment of peripheral blood stem cells CD34 + cell transplantation combined with oral sarpogrelate hydrochloride can significantly improve the vascular regener-ation and its blood supply in TAO lower extremity limb.
出处
《中国医师杂志》
CAS
2017年第12期1789-1791,1795,共4页
Journal of Chinese Physician
