Autologous peripheral blood stem cell transplantation combined with percutaneous transluminal angioplasty for diabetic lower extremity vascular disease / 中国组织工程研究

ABSTRACT

BACKGROUND:Studies have found that peripheral blood stem cel s can highly differentiate into vascular endothelial cel s to promote blood vessel regeneration, and improve col ateral circulation, thereby achieving satisfactory outcomes in the treatment of limb ischemia. OBJECTIVE:To observe the clinical effect in diabetic lower extremity vascular disease patients undergoing percutaneous transluminal angioplasty combined with autologous peripheral blood stem cel transplantation. METHODS:Fifty patients hospitalized for diabetic lower extremity vascular disease from March in 2011 to December in 2014 were col ected:25 cases underwent percutaneous transluminal angioplasty as control group;another 25 underwent percutaneous transluminal angioplasty combined with autologous peripheral blood stem cel transplantation as combination group. At 1, 6, 12 months after surgery, subjective scores of affected limb pain and cold sensation were recorded, additional y, objective indicators, including ankle-brachial index, transcutaneous oxygen partial pressure, and claudication distance were detected. RESULTS AND CONCLUSION:Ankle-brachial index scores of the two groups were significantly increased, especial y at 1 month after surgery, but decreased at 6, 12 months, and there was a significant difference compared with that before treatment (P0.05). At 1, 6, and 12 months after surgery, both of transcutaneous oxygen partial pressure and claudication distance in the two groups were significantly increased compared with those before treatment (P<0.05). Furthermore, compared with the control group, these two indicators in the combination group were significantly increased (P<0.05). Within 12-month follow-up, affected limb pain and cold sensation were improved in the two groups, especial y in the combination group. Inevitably, three cases had hypocalcemia during the col ection of peripheral blood stem cel s, and two cases developed fever and 3 cases appeared to have local exudation after surgery. All these symptoms were released by symptomatic treatments, respectively. In conclusion, percutaneous transluminal angioplasty combined with autologous peripheral blood stem cel transplantation for diabetic lower extremity vascular lesions can promote the establishment of affected limb col ateral circulation, to decrease the risk of limb ischemia, which achieves significant outcomes than percutaneous transluminal angioplasty used alone.