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目的:评价自体外周血单个核细胞(auto-peripheral blood mononuclear cell,auto-PBMNC)治疗血栓闭塞脉管炎(thromboangiitis obliterans,TAO)重度下肢缺血(critical limb ischemia,CLI)的长期疗效。方法:收集2004年7月至2013年5月本院22例血栓闭塞性脉管炎患者的临床资料。患者分为2组:1组12例接受auto-PBMNC治疗(auto-PBMNC组);另1组10例接受保守治疗(保守治疗组)。随访所有患者治疗后2年内溃疡愈合、脱离CLI、截肢、死亡及不良反应情况。结果:auto-PBMNC组的溃疡愈合情况和脱离CLI情况明显优于保守治疗组(溃疡愈合:P=0.016,脱离CLI:P=0.013)。2组2年截肢率无统计学差异(大截肢:P=0.361,总截肢P=0.867)。2年内无死亡病例、无严重不良反应。结论:与保守治疗相比,auto-PBMNC治疗能明显促进TAO患者溃疡愈合及脱离CLI,但两者对截肢的影响相同。
Objective: To evaluate the long-term efficacy of auto-peripheral blood mononuclear cell (auto-PBMNC) in the treatment of severe limb ischemia (CLI) in thromboangiitis obliterans (TAO). Methods: The clinical data of 22 patients with thromboangiitis obliterans in our hospital from July 2004 to May 2013 were collected. The patients were divided into two groups: one group received auto-PBMNC in 12 cases (auto-PBMNC group) and the other group received conservative treatment (conservative treatment group) in 10 cases. All patients were followed up 2 years after treatment ulcer healing, detachment CLI, amputation, death and adverse reactions. Results: The ulcer healing and detachment from the CLI in the auto-PBMNC group were significantly better than those in the conservative treatment group (ulcer healing: P = 0.016, detachment from the CLI: P = 0.013). There was no significant difference in 2-year amputation rate between the two groups (major amputation: P = 0.361, total amputation P = 0.867). No deaths within 2 years, no serious adverse reactions. CONCLUSION: Compared with conservative treatment, auto-PBMNC treatment can significantly promote the healing of ulcers and detachment of CLI in patients with TAO, but both have the same effect on amputation.