中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2014年
45期
7333-7336
,共4页
干细胞%移植%下肢动脉缺血%干细胞临床应用%自体外周血干细胞%血流重建%血管新生%云南省自然科学基金
榦細胞%移植%下肢動脈缺血%榦細胞臨床應用%自體外週血榦細胞%血流重建%血管新生%雲南省自然科學基金
간세포%이식%하지동맥결혈%간세포림상응용%자체외주혈간세포%혈류중건%혈관신생%운남성자연과학기금
lower extremity%ischemia%angioplasty%peripheral blood stem cel transplantation%neovascularization,physiologic
背景：探寻血管腔内修复术后二次肢体血流重建的方法也是该学科领域中最迫切的研究课题之一。目的：探讨自体干细胞移植衍生的新生血管主导和完善缺血态组织二次血流重建效应的生物学机制。<br> 方法：下肢动脉缺血性疾病患者42例，第1次血流重建方法选择血管腔内修复术，第2次血流重建方法选择自体外周血干细胞移植，于首次术后3个月实施，自体外周血干细胞移植后随访4年。<br> 结果与结论：自体外周血干细胞移植后自觉小腿区静息痛明显减轻，间隙性跛行距离显著延长，保肢率100%；患者肢体局部血流量变效应指标皮温指数为1.6±0.3，经皮氧分压为(5.00±1.26) kPa，踝肱指数为0.9±0.2，光电容积微血流态指数为0.8±0.1，血氧饱和度为(79.4±20.4)%，数字减影血管造影评分为1.3±0.2，各项指标均较移植前有显著改善。移植后下肢局部血流量变效应指标与肢体局部症状变化指标呈正相关(0.6< r <0.7，P<0.05)。结果可见干细胞源性新生血管量及其供给组织的持久有效的血液灌注量是主导和完善缺血态组织二次血流重建效应的主要生物学机制。
揹景：探尋血管腔內脩複術後二次肢體血流重建的方法也是該學科領域中最迫切的研究課題之一。目的：探討自體榦細胞移植衍生的新生血管主導和完善缺血態組織二次血流重建效應的生物學機製。<br> 方法：下肢動脈缺血性疾病患者42例，第1次血流重建方法選擇血管腔內脩複術，第2次血流重建方法選擇自體外週血榦細胞移植，于首次術後3箇月實施，自體外週血榦細胞移植後隨訪4年。<br> 結果與結論：自體外週血榦細胞移植後自覺小腿區靜息痛明顯減輕，間隙性跛行距離顯著延長，保肢率100%；患者肢體跼部血流量變效應指標皮溫指數為1.6±0.3，經皮氧分壓為(5.00±1.26) kPa，踝肱指數為0.9±0.2，光電容積微血流態指數為0.8±0.1，血氧飽和度為(79.4±20.4)%，數字減影血管造影評分為1.3±0.2，各項指標均較移植前有顯著改善。移植後下肢跼部血流量變效應指標與肢體跼部癥狀變化指標呈正相關(0.6< r <0.7，P<0.05)。結果可見榦細胞源性新生血管量及其供給組織的持久有效的血液灌註量是主導和完善缺血態組織二次血流重建效應的主要生物學機製。
배경：탐심혈관강내수복술후이차지체혈류중건적방법야시해학과영역중최박절적연구과제지일。목적：탐토자체간세포이식연생적신생혈관주도화완선결혈태조직이차혈류중건효응적생물학궤제。<br> 방법：하지동맥결혈성질병환자42례，제1차혈류중건방법선택혈관강내수복술，제2차혈류중건방법선택자체외주혈간세포이식，우수차술후3개월실시，자체외주혈간세포이식후수방4년。<br> 결과여결론：자체외주혈간세포이식후자각소퇴구정식통명현감경，간극성파행거리현저연장，보지솔100%；환자지체국부혈류량변효응지표피온지수위1.6±0.3，경피양분압위(5.00±1.26) kPa，과굉지수위0.9±0.2，광전용적미혈류태지수위0.8±0.1，혈양포화도위(79.4±20.4)%，수자감영혈관조영평분위1.3±0.2，각항지표균교이식전유현저개선。이식후하지국부혈류량변효응지표여지체국부증상변화지표정정상관(0.6< r <0.7，P<0.05)。결과가견간세포원성신생혈관량급기공급조직적지구유효적혈액관주량시주도화완선결혈태조직이차혈류중건효응적주요생물학궤제。
BACKGROUND:To explore the methods for secondary limb revascularization after endovascular repair is one of the most urgent research topics. <br> OBJECTIVE:To investigate the biological mechanism about the transplantation of autologous peripheral blood stem cel s to lead and perfect the effect of ischemic tissue for secondary revascularization. <br> METHODS:Forty-two patients with critical low limb ischemia were selected and treated with endovascular repair as first revascularization and transplantation of autologous peripheral blood stem cel s as secondary revascularization. The secondary revascularization was carried out at 3 months after the first blood flow remodeling. The patients receiving secondary revascularization were fol owed for 4 years. <br> RESULTS AND CONCLUSION:After transplantation of autologous peripheral blood stem cel s, the patients complained that the rest pain of the lower leg was relieved obviously and intermittent claudication distance was significantly lengthened. Limb salvage rate was 100%. Skin temperature index was 1.6±0.3, transcutaneous oxygen pressure was (5.00±1.26) kPa, ankle-brachium index was 0.9±0.2, photoplethysmograpy index was 0.8±0.1, saturation of blood oxygen was (79.4±20.4)%, and digital subtraction angiography score was (1.3±0.2) <br> points. After transplantation, local blood flow indicators of the low limbs were positively correlated to local symptom indicators of the limbs (0.6<r<0.7, P<0.05). These results strongly suggest that the stem cel s-derived neovascularization can offer effective and permanent blood flow perfusions to the ischemic tissue, and this biological effect play an important role in secondary revascularization of the ischemic tissue.
