经皮血管腔内成形术联合自体外周血单个核细胞治疗糖尿病足下肢血管病变的临床研究

目的:探讨经皮血管腔内成形术(PTA)联合自体外周血单个核细胞(PBMNCs)移植治疗糖尿病足下肢血管病变的临床疗效。方法:选取内蒙古医科大学第二附属医院2016年8月至2017年9月期间收治的糖尿病足下肢血管病变患者共120例,按随机数字表法分为3组:对照1组共40例,进行自体PBMNCs移植;对照2组共40例,进行PTA治疗;联合治疗组共40例,在进行PTA治疗的同时于缺血部位注入PBMNCs。观察3组的血管疏通情况,比较治疗前、治疗后1、6、12个月的跛行距离、踝肱指数(ABI),记录3组并发症发生情况。结果:联合治疗组患者的手术成功率为100.00%(40/40),高于对照1组的40.00%(16/40)、对照2组的55.00%(22/40),差异有统计学意义(P0.05)。治疗后1、6、12个月联合治疗组的跛行距离、ABI高于对照1组和对照2组(P0.05)。联合治疗组并发症总发生率为5.00%(2/40),低于对照1组的37.50%(15/40)和对照2组的25.00%(10/40),差异有统计学意义(P0.05)。结论:PTA联合自体PBMNCs移植是一种安全、有效、微创的治疗糖尿病足下肢血管病变的方法,其能够改善患者的血管疏通和病情。

Clinical Study of Percutaneous Transluminal Angioplasty Combined with Autologous Peripheral Blood Mononuclear Cell transplantation in the Treatment of Diabetic Foot and Lower Extremity Vascular Disease

ABSTRACT Objective: To investigate the clinical effect of percutaneous transluminal angioplasty (PTA) combined with autologous peripheral blood mononuclear cells (PBMNCs) transplantation in the treatment of diabetic foot and lower extremity vascular disease. Methods: 120 patients with diabetic foot and lower extremity vascular disease who were treated in the Second Affiliated Hospital of Inner Mongolia Medical University from August 2016 to September 2017 were selected. They were divided into three groups according to the random number table, the control group 1 with 40 cases conducted the PBMNCs transplantation, the control group 2 with 40 cases were treated with PTA, and the combined treatment group with 40 cases was injected with PBMNCs at the site of ischemia while undergoing PTA treatment. The patency of blood vessels in the three groups were observed. The claudication distance and ankle brachial index (ABI) were compared before treatment and 1, 6, 12 months after treatment. The complications of the three groups were recorded. Results: The success rate in the combined treatment group was 100.00%(40/40), which was higher than that 40.00% in the control group 1 (16/40) and 55.00% in the control group 2(22/40), and the differences were statistically significant(P<0.05). The claudication distance and ABI of the combined treatment group at 1,6 and 12 months after treatment were higher than those of the control group 1 and the control group 2 (P<0.05). The total response rate of complications in the combined treatment group was 5.00%(2/40), which was lower than 37.50% (15/40) in the control group 1 and 25.00% (10/40) in the control group 2, the differences were statistically significant(P<0.05). Conclusion: PTA combined with autologous PBMNCs transplantation is a safe, effective and minimally invasive method for the treatment of diabetic foot and lower extremity vascular disease, it can improve vascular dredging and condition of patients.