Arai Masazumi, Misao Yu, Nagai Hiroshi, Kawasaki Masanori, Nagashima Kenshi, Suzuki Koji, Tsuchiya Kunihiko, Otsuka Setsuko, Uno Yoshihiro, Takemura Genzou, Nishigaki Kazuhiko, Minatoguchi Shinya, Fujiwara Hisayoshi
Department of Cardiology, Regeneration Medicine and Bioethics, Gifu University Graduate School of Medicine, Japan.
Circ J. 2006 Sep;70(9):1093-8. doi: 10.1253/circj.70.1093.
The purpose of this study was to determine whether treatment with granulocyte colony-stimulating factor (G-CSF), which mobilizes endothelial progenitor cells from bone marrow, can safely improve the clinical outcomes of patients with atherosclerotic peripheral artery disease (PAD).
Thirty-nine patients with intractable PAD were randomly assigned to 3 groups: a negative control group (n=12) treated with conventional drug therapy; a positive control group (n=13) treated with conventional drug therapy plus bone marrow transplantation (BMT); and a G-CSF group (n=14) treated with conventional therapy plus subcutaneous injection of 2-5 microg/kg of recombinant human G-CSF once daily for 10 days. One month after treatment, subjective symptoms improved significantly in the G-CSF and BMT groups. Ankle-brachial pressure index and transcutaneous oxygen pressure increased significantly in the BMT and G-CSF groups, but no such improvements were seen in the group receiving conventional therapy alone.
G-CSF improves the clinical signs and symptoms of patients with intractable PAD to the same degree as BMT does. This noninvasive treatment may thus represent a useful new approach to managing the disease.
本研究旨在确定用粒细胞集落刺激因子(G-CSF)进行治疗,即从骨髓中动员内皮祖细胞,是否能安全改善动脉粥样硬化性外周动脉疾病(PAD)患者的临床结局。
39例难治性PAD患者被随机分为3组:阴性对照组(n = 12)接受传统药物治疗;阳性对照组(n = 13)接受传统药物治疗加骨髓移植(BMT);G-CSF组(n = 14)接受传统治疗加皮下注射2 - 5微克/千克重组人G-CSF,每日1次,共10天。治疗1个月后,G-CSF组和BMT组的主观症状显著改善。BMT组和G-CSF组的踝臂压力指数和经皮氧分压显著升高,但仅接受传统治疗的组未出现此类改善。
G-CSF改善难治性PAD患者的临床体征和症状的程度与BMT相同。因此,这种非侵入性治疗可能是管理该疾病的一种有用的新方法。