Gabr Hala, Hedayet Ashraf, Imam Usama, Nasser Mahmoud
Department of Clinical Pathology, Faculty of Medicine, Cairo University.
Exp Clin Transplant. 2011 Jun;9(3):197-202.
Despite advances in surgical and radiologic vascular techniques, many patients with critical limb ischemia are not eligible for revascularization procedures. Without pharmacologic therapy, the only option left is amputation. Bone marrow-derived progenitor cells represent a good revascularization option. This study sought to evaluate the therapeutic effectiveness of autologous unfractionated bone marrow mononuclear cell injection in revascularization of critical limb ischemia patients.
Twenty critical limb ischemia patients were not eligible for open or endo-vascular interventions. Bone marrow mononuclear cells were obtained by aspiration of 300 mL bone marrow, injected intramuscular in affected muscles. Patients were followed-up by walking distance, resting pain, skin condition, and ankle brachial index.
Walking distance improved from a mean of 56 meters to a mean of 132 meters; rest pain improved markedly in 50% of patients, mildly in 5% of patients, and was unaffected in 45% of the patients. Fifty percent of patients showed improved skin condition, while ankle brachial index showed improvement in 40% of patients. No procedure-related complications were encountered.
Autologous bone marrow mononuclear cell injection provides a safe and effective option for critical limb ischemia patients.
尽管外科和放射血管技术取得了进展，但许多严重肢体缺血患者仍不符合血管重建手术的条件。若不进行药物治疗，剩下的唯一选择就是截肢。骨髓来源的祖细胞是一种良好的血管重建选择。本研究旨在评估自体未分级骨髓单个核细胞注射对严重肢体缺血患者血管重建的治疗效果。
20例严重肢体缺血患者不符合开放或血管内介入治疗条件。通过抽取300 mL骨髓获取骨髓单个核细胞，注射到受影响肌肉的肌内。通过步行距离、静息痛、皮肤状况和踝肱指数对患者进行随访。
步行距离从平均56米提高到平均132米；50%的患者静息痛明显改善，5%的患者轻度改善，45%的患者未受影响。50%的患者皮肤状况改善，而踝肱指数在40%的患者中有所改善。未遇到与手术相关的并发症。
自体骨髓单个核细胞注射为严重肢体缺血患者提供了一种安全有效的选择。
