关键四肢缺血症患者自身骨髓干细胞不符合再血管化的条件:一个单一中心的经验
Pietro Modugno1, Savino Cilla2, Enrico Maria Centritto1
1Vascular Surgery Unit, Gemelli Molise Hospital, Campobasso, Italy.
Angiology
|September 20, 2023
概括
自主骨髓干细胞移植提供了安全有效的治疗关键四肢缺血症的患者不符合再血管化的资格. 这种方法在80名患者中的59名患者中成功保存了四肢,避免了截肢.
科学领域:
- 再生医学是一种再生医学.
- 血管外科 血管外科
- 血液学 血液学 血液学
背景情况:
- 关键四肢缺血症 (CLI) 对无法接受再血管化的患者造成截肢的重大风险.
- 自主骨髓干细胞代表了在CLI中挽救四肢的潜在治疗选择.
- 对这种患者群体来说,评估干细胞移植的有效性和安全性至关重要.
研究的目的:
- 评估CLI患者在自身骨髓干细胞移植后的无截肢率.
- 评估穿皮氧 (TcpO2) 作为截肢风险的预测指标.
- 分析干细胞治疗对CLI患者休息疼痛的影响.
主要方法:
- 一个单一中心的回顾性研究,涉及80名连续的CLI患者,预计要截肢.
- 所有患者都接受了自身骨髓干细胞移植.
- 主要终点:没有截肢的比率. 二级终点:TcpO2测量,休息疼痛评估,脚-手臂指数和放射性成像.
主要成果:
- 在80名候选大腿截肢的患者中,59名 (73.75%) 的肢体被保存.
- 透皮氧 (TcpO2) 证明了截肢风险的预测值 (AUC = 0.763),值≤22.7 mmHg和≤26.9 mmHg表明风险更高.
- 两名患者死于与此无关的并发症,19名患者进行了截肢.
结论:
- 自主骨髓干细胞移植是一种安全有效的治疗,用于关键四肢缺血症的患者不符合再血管化的资格.
- 在接受干细胞治疗的CLI患者中,TCpO2是预测截肢风险的宝贵工具.
- 干细胞疗法为肢体救援提供了一个有希望的替代方案,改善了结果并保持了肢体功能.
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