CAJ | 학술논문

干细胞%干细胞临床实践%脐带间充质干细胞%骨髓干细胞%脐血干细胞%细胞移植%踝肱指数%神经传导速度%糖尿病足%缺血性病变%神经病变榦細胞%榦細胞臨床實踐%臍帶間充質榦細胞%骨髓榦細胞%臍血榦細胞%細胞移植%踝肱指數%神經傳導速度%糖尿病足%缺血性病變%神經病變
간세포%간세포림상실천%제대간충질간세포%골수간세포%제혈간세포%세포이식%과굉지수%신경전도속도%당뇨병족%결혈성병변%신경병변
stem cel s%umbilical cord-derived mesenchymal stem cel s%bone marrow stem cel s%umbilical cord blood stem cells%cell transplantation%ankle/brachial index%nerve conduction velocity%diabetic foot%ischemic lesions%neuropathy

背景:以自体骨髓、脐血单个核细胞移植治疗糖尿病足,对缺血性病变及周围神经损伤所致临床症状有改善作用,对糖尿病足也有较好的疗效.脐带间充质干细胞与骨髓干细胞和脐血干细胞相比有其自身的优势.目的:观察脐带间充质干细胞移植治疗糖尿病足病缺血及神经损伤的疗效.方法:选取2010至2012年住院行脐带间充质干细胞移植治疗的糖尿病足病患者32例,将脐带间充质干细胞稀释后行双下肢肌肉内注射,每个注射点间隔约3 cm,每个肢体移植(5.02±1.37)×108个月和6个月后评价其下肢缺血和下肢周围神经病变情况.并检索CNKI数据库,对国内干细胞移植治疗糖尿病足的研究状况进行分析.结果与结论:移植后踝肱指数升降不一,移植后6个月疼痛评分及冷感评分明显改善,间歇性跛行及皮肤温度、经皮氧分压治疗后3,6个月与移植前比较差异均有显著性意义;对神经病变损伤自觉症状评分、临床检查评分、振动感觉阀值移植后6个月与移植前比较差异有显著性意义.腓浅神经、胫神经感觉神经传导速度,腓总神经、胫神经运动神经传导速度,在移植后3个月与移植前比较,差异无显著性意义(P>0.05),移植6个月与移植前相比较有升高,差异有显著性意义(P<0.05).可见脐带间充质干细胞可以改善糖尿病缺血性病变及周围神经病变的临床症状及客观指标.文献分析结果发现,已有的研究中治疗结果都比较理想,多数研究中的移植方法为进行肌肉注射.
배경:이자체골수、제혈단개핵세포이식치료당뇨병족,대결혈성병변급주위신경손상소치림상증상유개선작용,대당뇨병족야유교호적료효.제대간충질간세포여골수간세포화제혈간세포상비유기자신적우세.목적:관찰제대간충질간세포이식치료당뇨병족병결혈급신경손상적료효.방법:선취2010지2012년주원행제대간충질간세포이식치료적당뇨병족병환자32례,장제대간충질간세포희석후행쌍하지기육내주사,매개주사점간격약3 cm,매개지체이식(5.02±1.37)×108개월화6개월후평개기하지결혈화하지주위신경병변정황.병검색CNKI수거고,대국내간세포이식치료당뇨병족적연구상황진행분석.결과여결론:이식후과굉지수승강불일,이식후6개월동통평분급랭감평분명현개선,간헐성파행급피부온도、경피양분압치료후3,6개월여이식전비교차이균유현저성의의;대신경병변손상자각증상평분、림상검사평분、진동감각벌치이식후6개월여이식전비교차이유현저성의의.비천신경、경신경감각신경전도속도,비총신경、경신경운동신경전도속도,재이식후3개월여이식전비교,차이무현저성의의(P>0.05),이식6개월여이식전상비교유승고,차이유현저성의의(P<0.05).가견제대간충질간세포가이개선당뇨병결혈성병변급주위신경병변적림상증상급객관지표.문헌분석결과발현,이유적연구중치료결과도비교이상,다수연구중적이식방법위진행기육주사.
BACKGROUND:Autologous bone marrow and umbilical blood mononuclear cel transplantation can improve the clinical symptoms caused by ischemic lesions and peripheral nerve injury, and have good effect on diabetic foot. Umbilical cord-derived mesenchymal stem cel s have their own advantages when compared with bone marrow stem cel s and umbilical cord blood stem cel s. OBJECTIVE:To observe the effect of umbilical cord-derived mesenchymal stem cel s on diabetic foot ischemic lesions and peripheral nerve injury. METHODS:Thirty-two patients with diabetic foot who received umbilical cord-derived mesenchymal stem cel transplantation from 2010 to 2012 were selected. Umbilical cord-derived mesenchymal stem cel s were intramuscularly injected into the bilateral lower extremities with 3 cm distance between two injection sites after dilution. The number of implanted cel s was (5.02±1.37) ×108 per leg. The lower extremity ischemia and lower extremity peripheral neuropathy were evaluated at 3 and 6 months after injection. The CMKI database was searched for the literatures in order to analyze the research situation of stem cel transplantation for the treatment of diabetic foot in China. RESULTS AND CONCLUSION:There was no significant difference in ankle/brachial index after treatment. The pain score and the apathetic score were significantly improved at 6 months after transplantation. There were significant differences in angina cruris, skin temperature and transcutaneous oxygen partial pressure after 3 or 6 months of treatment. After treatment for 6 months, there were significant differences in rational symptom score, clinical examination score and vibration perception threshold. There were no significant differences in the conduction velocity of motor/sensory nerves of peroneal nerve and tibial nerve at 3 months after transplantation when compared with those before transplantation (P>0.05), and there were significant differences at 6 months after transplantation when compared with those before transplantation (P<0.05). The clinical symptoms and objective indexes of diabetic ischemic lesions and peripheral neuropathy can be improved by umbilical cord-derived mesenchymal stem cel s. Literatures analysis has shown that the therapeutic effect in the existing research is satisfactory, and the transplantation method in most researches is consistent with that in this research.