Department of Vascular Surgery, Xuanwu Hospital Capital Medical University, Beijing, China.
Institute of Vascular Surgery, Capital Medical University, Beijing, China.
Stem Cell Res Ther. 2018 Feb 22;9(1):43. doi: 10.1186/s13287-018-0784-6.
For patients with thromboangiitis obliterans (TAO), revascularization with bypass or angioplasty is frequently not feasible due to the poor outflow of the distal small vessels. We evaluated the long-term results of our experience treating patients with TAO with autologous bone marrow-derived mononuclear cells (ABMMNCs) to determine the safety and efficacy of ABMMNC therapy in patients with critical limb ischemia due to TAO.
This was a retrospective chart review from a single university hospital vascular surgery center between January 2005 and July 2006. Patients were treated with smoking cessation and either aspirin (100 mg/day) alone or aspirin and ABMMNC injection according to patient preference. Groups were compared for demographics, clinical characteristics, and short-term and long-term results.
Of 59 patients with TAO who were treated, 19 patients elected aspirin alone and 40 patients elected aspirin and ABMMNC injection. No patients suffered perioperative complications and 49 (83%) patients remained smoke-free for 10 years. The 10-year amputation-free survival was 85.3% (29/34) in patients treated with ABMMNCs compared to 40% (6/15) in patients treated with aspirin alone (p = 0.0019). Ulcer area (p < 0.0001), toe-brachial index (TBI; p < 0.0001), transcutaneous oxygen pressure (TcPO; p < 0.0001), and pain score (p < 0.0001) were also significantly improved with ABMMNC treatment, although there was no difference in mean ankle-brachial index (ABI; p = 0.806).
In patients with critical limb ischemia due to TAO, ABMMNC treatment was safe and effective. ABMMNC treatment significantly improved amputation-free survival, ulcer healing, and pain, although there is no difference in ABI compared to treatment with aspirin alone.
对于血栓闭塞性脉管炎（TAO）患者，由于远端小血管流出不良，旁路或血管成形术再血管化通常不可行。我们评估了我们用自体骨髓源性单核细胞（ABMMNC）治疗 TAO 患者的经验的长期结果，以确定 ABMMNC 治疗 TAO 引起的严重肢体缺血患者的安全性和有效性。
这是一家单一大学医院血管外科中心在 2005 年 1 月至 2006 年 7 月期间进行的回顾性图表审查。根据患者的喜好，患者接受戒烟和单独使用阿司匹林（每天 100 毫克）或阿司匹林和 ABMMNC 注射治疗。比较了两组患者的人口统计学、临床特征以及短期和长期结果。
在 59 例 TAO 患者中，有 19 例患者选择单独使用阿司匹林，40 例患者选择阿司匹林和 ABMMNC 注射。没有患者发生围手术期并发症，49（83%）例患者 10 年内保持不吸烟。接受 ABMMNC 治疗的患者 10 年无截肢生存率为 85.3%（29/34），而单独接受阿司匹林治疗的患者为 40%（6/15）（p=0.0019）。溃疡面积（p<0.0001）、趾肱指数（TBI；p<0.0001）、经皮氧压（TcPO；p<0.0001）和疼痛评分（p<0.0001）也因 ABMMNC 治疗而显著改善，尽管平均踝肱指数（ABI；p=0.806）无差异。
在 TAO 引起的严重肢体缺血患者中，ABMMNC 治疗是安全有效的。ABMMNC 治疗可显著提高无截肢生存率、溃疡愈合率和疼痛缓解率，尽管与单独使用阿司匹林治疗相比，ABI 无差异。
