中国医药
中國醫藥
중국의약
CHINA MEDICINE
2011年
11期
1354-1357
,共4页
吴石白%关小宏%王恒湘%王良宸%王敏%肖黎%薛梅%朱培瑜%童奥%唐红%杨彩哲%王璐宁%赵永东%王珠红
吳石白%關小宏%王恆湘%王良宸%王敏%肖黎%薛梅%硃培瑜%童奧%唐紅%楊綵哲%王璐寧%趙永東%王珠紅
오석백%관소굉%왕항상%왕량신%왕민%초려%설매%주배유%동오%당홍%양채철%왕로저%조영동%왕주홍
肝细胞生长因子%糖尿病%闭塞性动脉硬化症%糖尿病足
肝細胞生長因子%糖尿病%閉塞性動脈硬化癥%糖尿病足
간세포생장인자%당뇨병%폐새성동맥경화증%당뇨병족
Hepatocyte growth factor%Diabetes%Arteriosclerosis occlusion%Diabetes foot
目的 探讨利用肝细胞生长因子(HGF)基因联合骨髓间充质干细胞治疗糖尿病周围动脉硬化闭塞症(PAD)和糖尿病足的临床疗效.方法 将Fontaine分级Ⅲ～Ⅳ级的糖尿病PAD及糖尿病足患者30例完全随机分为2组.研究组(16例)采用携带人HGF基因的质粒DNA( HGF-PVAX1 )4 mg联合骨髓动员后的于细胞,局部注射于患肢腓肠肌；对照组(14例)于患肢腓肠肌局部注射单纯骨髓动员后的于细胞.分别于移植术后1、3、6个月比较2组在干细胞局部注射治疗前后的临床疗效.结果 2组患者间歇性跛行有好转.研究组术前与术后6个月的下肢踝/肱指数(ABI)分别为(0.346±0.036)、(0.596±0.036),对照组是(0.379±0.031)、(0.468±0.032).2组术后与术前相比,差异均有统计学意义(均P＜0.05)；术后研究组ABI水平高于对照组,差异亦有统计学意义(P＜0.05).研究组术后皮温平均为(35.9±1.8)℃,术前为(33.4±2.1)℃；对照组术后皮温平均为(33.1±1.3)℃,术前为(33.7±1.5)℃.2组皮温变化程度比较,差异有统计学意义(P＜0.05).2组移植后3个月复查下肢动脉彩色超声,股浅动脉、腘动脉未见明显变化.研究组移植前足背动脉血流量≥20 ml/min者8例,15 ～ 19 ml/min者4例,1～ 14 ml/min者2例,0 ml/min者2例；移植后≥20 ml/min者10例,15 ～ 19 ml/min者2例,1～14 ml/min者2例,0ml/min者2例.对照组移植前足背动脉血流量≥20 ml/min者6例,15～19 ml/min者3例,1～14 ml/min者3例,0ml/min者2例；移植后≥20 ml/min者7例,15～19 ml/min者2例,l～ 14 ml/min者3例,0 ml/min者2例.研究组移植后足背动脉血流量改善情况好于对照组,差异有统计学意义(P＜0.05).2组间不良反应发生率差异无统计学意义.结论 注射HGF-PVAXl联合骨髓干细胞移植可在一定程度上改善肢体缺血,可能成为治疗PAD的一种新手段.但其远期疗效和安全性还有待观察.
目的 探討利用肝細胞生長因子(HGF)基因聯閤骨髓間充質榦細胞治療糖尿病週圍動脈硬化閉塞癥(PAD)和糖尿病足的臨床療效.方法 將Fontaine分級Ⅲ～Ⅳ級的糖尿病PAD及糖尿病足患者30例完全隨機分為2組.研究組(16例)採用攜帶人HGF基因的質粒DNA( HGF-PVAX1 )4 mg聯閤骨髓動員後的于細胞,跼部註射于患肢腓腸肌；對照組(14例)于患肢腓腸肌跼部註射單純骨髓動員後的于細胞.分彆于移植術後1、3、6箇月比較2組在榦細胞跼部註射治療前後的臨床療效.結果 2組患者間歇性跛行有好轉.研究組術前與術後6箇月的下肢踝/肱指數(ABI)分彆為(0.346±0.036)、(0.596±0.036),對照組是(0.379±0.031)、(0.468±0.032).2組術後與術前相比,差異均有統計學意義(均P＜0.05)；術後研究組ABI水平高于對照組,差異亦有統計學意義(P＜0.05).研究組術後皮溫平均為(35.9±1.8)℃,術前為(33.4±2.1)℃；對照組術後皮溫平均為(33.1±1.3)℃,術前為(33.7±1.5)℃.2組皮溫變化程度比較,差異有統計學意義(P＜0.05).2組移植後3箇月複查下肢動脈綵色超聲,股淺動脈、腘動脈未見明顯變化.研究組移植前足揹動脈血流量≥20 ml/min者8例,15 ～ 19 ml/min者4例,1～ 14 ml/min者2例,0 ml/min者2例；移植後≥20 ml/min者10例,15 ～ 19 ml/min者2例,1～14 ml/min者2例,0ml/min者2例.對照組移植前足揹動脈血流量≥20 ml/min者6例,15～19 ml/min者3例,1～14 ml/min者3例,0ml/min者2例；移植後≥20 ml/min者7例,15～19 ml/min者2例,l～ 14 ml/min者3例,0 ml/min者2例.研究組移植後足揹動脈血流量改善情況好于對照組,差異有統計學意義(P＜0.05).2組間不良反應髮生率差異無統計學意義.結論 註射HGF-PVAXl聯閤骨髓榦細胞移植可在一定程度上改善肢體缺血,可能成為治療PAD的一種新手段.但其遠期療效和安全性還有待觀察.
목적 탐토이용간세포생장인자(HGF)기인연합골수간충질간세포치료당뇨병주위동맥경화폐새증(PAD)화당뇨병족적림상료효.방법 장Fontaine분급Ⅲ～Ⅳ급적당뇨병PAD급당뇨병족환자30례완전수궤분위2조.연구조(16례)채용휴대인HGF기인적질립DNA( HGF-PVAX1 )4 mg연합골수동원후적우세포,국부주사우환지비장기；대조조(14례)우환지비장기국부주사단순골수동원후적우세포.분별우이식술후1、3、6개월비교2조재간세포국부주사치료전후적림상료효.결과 2조환자간헐성파행유호전.연구조술전여술후6개월적하지과/굉지수(ABI)분별위(0.346±0.036)、(0.596±0.036),대조조시(0.379±0.031)、(0.468±0.032).2조술후여술전상비,차이균유통계학의의(균P＜0.05)；술후연구조ABI수평고우대조조,차이역유통계학의의(P＜0.05).연구조술후피온평균위(35.9±1.8)℃,술전위(33.4±2.1)℃；대조조술후피온평균위(33.1±1.3)℃,술전위(33.7±1.5)℃.2조피온변화정도비교,차이유통계학의의(P＜0.05).2조이식후3개월복사하지동맥채색초성,고천동맥、객동맥미견명현변화.연구조이식전족배동맥혈류량≥20 ml/min자8례,15 ～ 19 ml/min자4례,1～ 14 ml/min자2례,0 ml/min자2례；이식후≥20 ml/min자10례,15 ～ 19 ml/min자2례,1～14 ml/min자2례,0ml/min자2례.대조조이식전족배동맥혈류량≥20 ml/min자6례,15～19 ml/min자3례,1～14 ml/min자3례,0ml/min자2례；이식후≥20 ml/min자7례,15～19 ml/min자2례,l～ 14 ml/min자3례,0 ml/min자2례.연구조이식후족배동맥혈류량개선정황호우대조조,차이유통계학의의(P＜0.05).2조간불량반응발생솔차이무통계학의의.결론 주사HGF-PVAXl연합골수간세포이식가재일정정도상개선지체결혈,가능성위치료PAD적일충신수단.단기원기료효화안전성환유대관찰.
Objective To investigate the clinical effect about the gene therapy for peripheral arterial disease (PAD) and the diabetic foot ulcer(DFU) using plasmid DNA encoding human hepatocyte growth factor(HGF)gene.Methods Totally Thrity cases who had suffered from the PAD in diabetes with grade of Fontaine Ⅲ ～ Ⅳ were selected.30 cases were divided into two groups at random,open,control study,which is A and B group.Sixteen cases were in group A,namely study group.Forteen cases were in group B,namely control group.A group's patients were injected the human HGF plasmid DNA( HGF-PVAX1 )4 mg combining with the bone marrow stem cell into gastrocnemius.B group's patients were accepted the injection of bone marrow stem cell into gastrocnemius merely.We compared the clinical curative effect after the injection of the stem cell into gastrocnemius before and l,3,6 months after the stem cell transplantation operation.Results Symptom of the intermittence elaudication of patients in both groups was improved.In group A,the ankle brachial index (ABI) was (0.346 ± 0.036) and (0.596 ± 0.036) before and 6 months after the operation,while in group B,the ABI was (0.379 ± 0.031 ) and (0.468 ± 0.032).Skin temperature of lower extremities and dorsal feet was obviously improved after the transplantation.In A group,the average skin temperature was (33.4 ± 2.1 ) ℃C before and ( 35.9 ± 1.8 ) ℃C after the operation.Meanwhile,it was (33.7 ± 1.5 ) ℃ before and (33.1 ± 1.3 ) ℃ after the operation.A review by color Doppler ultrasound on lower extremity arteries was performed to all patients 3 months after the operation.There was no significant changes at superficial femoral and popliteal arteries.In A group,there were 8 cases' blood flow in dorsal artery before the operation were greater than or equal to 20 ml/min,4 were 15-19 ml/min,2 were 1-14 ml/min,2 without detectable blood flow; after the operation,there were 10,2,2 and 2 cases at the corresponding levels.In B group,there were 6 cases' blood flow in dorsal artery before the operation were greater than or equal to 20 rml/min,3 were 15-19 ml/min,3 were 1-14 ml/min,2 without detectable blood flow; after the operation,there were 7,2,3 and 2 cases at the corresponding levels.Blood flow in A group was better than that in B group( P ＜ 0.05 ).The incidence rate of the untoward effect had no statistical significance between the two groups.Conclusions Gastrocnemius injection of human HGF plasmid DNA( HGF-PVAX1 ) combined with the bone marrow stem cell can improve the limb ischemia at certainly extent.It will be a new method of treating PAD.
