Autoperipheral blood mononuclear cell transplantation improved giant ulcers due to chronic arteriosclerosis obliterans
Autoperipheral blood mononuclear cell transplantation improved giant ulcers due to chronic arteriosclerosis obliterans
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DOI：
10.1007/s00380-005-0869-x
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发表时间：
2006-07-01
影响因子：
1.5
通讯作者：
Hisatome, Ichiro
中科院分区：
文献类型：
--
作者：
Sugihara, Shinobu;Yamamoto, Yasutaka;Hisatome, Ichiro
我们报告的情况下，一个74岁的男子方丹第四阶段慢性动脉硬化闭塞症谁一直患有根深蒂固的巨大皮肤溃疡的背部和脚跟的右脚。由于传统的药物治疗没有改善这些溃疡，手术治疗被认为是不可行的，截肢的右下肢膝盖以下似乎是唯一的选择。该患者入住鸟取大学医院，尝试使用自体单核细胞移植进行新的血管生成治疗，以避免截肢。入院时，右踝血压和右脚趾经皮氧分压均未检测到。患者有多发性脑梗死病史，考虑骨髓单个核细胞采集太困难，故选择外周血单个核细胞采集。经皮氧分压和皮肤温度在植入后2周开始改善。治疗后1个月，溃疡大小明显缩小。治疗后2个月行右足跟部自体皮移植术，巨大皮肤溃疡完全覆盖。随访1年，未见不良反应。结果提示，外周血单个核细胞移植可为全身状况不佳的重症肢体缺血患者提供一种合适的替代抢救治疗方法。
We report the case of a 74-year-old man with Fontaine stage IV chronic arteriosclerosis obliterans who had been suffering from inveterate giant skin ulcers on the dorsum and heel of the right foot. As conventional medical treatments had not improved these ulcers and surgical treatment was considered unfeasible, amputation of the right lower limb below the knee appeared to represent the only option. The patient was admitted to Tottori University Hospital to attempt a new angiogenic therapy using auto-mononuclear cell transplantation to avoid amputation. On admission, neither right ankle blood pressure nor transcutaneous partial pressure of oxygen at the right toe were detectable. The patient had a history of multiple cerebral infarctions, and collection of mononuclear cells from bone marrow was considered too difficult, so collection of peripheral blood mononuclear cells was selected. Transcutaneous partial pressure of oxygen and skin temperature in the treated limb started to improve from 2 weeks after implantation. Ulcer size was recognizably reduced by 1 month after treatment. Partial auto-skin implantation on the right heel was performed 2 months after treatment, and the giant skin ulcer was finally completely covered. No adverse effects were noted during follow-up lasting 1 year. These results suggest that peripheral blood mononuclear cell implantation may offer a suitable alternative rescue therapy for patients with critical limb ischemia whose general condition is not good.