| Objective:Having operated autologous peripheral blood mononuclear cells transplantation on 59 patients with lower limb ischemia and analyzed the factors affecting the therapeutic effects, such as species of transplanted cells, quantity of transplanted cells, concentration of transplanted cells, transplanting opportunity, survival and proliferation of transplanted cells after operation, suggest on clinical practice including determination of types of diseases, species and quantity of cells and transplanting opportunity, et al; Methods:Assessed and evaluated the symptoms of all the patients before the therapy, then injected the cells onto multiple points at muscle-rich body positions at equal intervals after mobilizing and collecting the peripheral mononuclear cells from all patients. Subsequently, assessed and evaluated the symptoms of all patients at the 7th day and follow-up period respectively. Compared the correlation of CD34+cells and mononuclear cells with the therapeutic effects, and drew the relative formula between the cells and the therapeutic effects; Analyzed the correlation between concentration of mononuclear cells and therapeutic effects, and drew the relative formula between them; Compared the therapeutic effects of diabetic lower limb ischemia with non-diabetic lower limb ischemia; Compared the therapeutic effects of low arterial obstruction and high arterial obstruction; Analyzed the correlation of age, white blood cells and mononuclear cells for all patients; Analyzed the correlation of age, white blood cells and mononuclear cells and drew the relative formula for elderly patients; Analyzed the special types of disease, assessed and evaluated the range of indications and contraindications; And analyzed the causes of invalid cases; Results:After the mononuclear cells transplantations, the therapeutic effects at the 7th day and follow-up period have been improved to some extent, all factors influencing the therapeutic effects have been summarized and depict that mononuclear cells have a higher correlation with therapeutic effect than CD34+cells (nimodipine values represent therapeutic effects); The correlation between CD34+cells and therapeutic effect was R=0.461 (P=0.047) based on the formula of nimodipine value=0.484+1.055×CD34+cells quantity; The correlation between mononuclear cells and therapeutic effects was R=0.473 (P=0.000) based on the formula of nimodipine value=0.288+0.401 xmononuclear cells quantity; The correlation between the concentration of mononuclear cells and therapeutic effects was R=0.473 (P=0.000) and the formula was nimodipine value=0.361+0.177×the concentration of mononuclear cells quantity; There was no remarkable difference in the therapeutic effects between diabetic lower limb ischemia and non-diabetic lower limb ischemia; Except for the more improved rest pain and cold sensation at 7th day in the low arterial obstruction group, there was no remarkable difference in the therapeutic effects between low and high arterial obstruction groups; For all patients, the correlation between the white blood cells quantity and mononuclear cells quantity was R=0.315(P=0.015) and the formula was mononuclear cells quantity=0.361+0.177×white blood cells quantity; Excluding the thrombosis phlebitis patients which were almost middle age and young persons, the rest patients were elderly people, the correlation between the white blood cells quantity and mononuclear cells quantity was R=0.500(P=0.000) based on the formula of mononuclear cells quantity=0.016+0.067×white blood cells quantity, comparatively the R value was higher than the average of all patients; For these elderly patients, the correlation between the neutrophil cells quantity and mononuclear cells quantity was R=0.458 (P=0.024), the formula was mononuclear cells quantity=0.005+0.063xneutrophil cells quantity; Through analyzing the special types of disease, mononuclear cells transplantation can also have therapeutic effects on essential thrombocythemia and secondary embolization after artificial vascular bypass surgery; And invalid cases were the complicated cases with severe gangrene or vein thrombosis. Conclusion:Autologous peripheral blood mononuclear cells suspension comprises of different stages of cells which can promote angiogenesis and has the niche advantage, so it may have better therapeutic effects than endothelial progenitor cells (EPC) and CD34+cells transplantation. Even for the diabetic patients who have decreasing quantity and quality of EPC, the same effect is achievable because of the special advantages of mononuclear cells. In addition, the range of indications and contraindications is advisably to be re-assessed and re-determined and the types of disease applicable are suggested to extend to other diseases which lead to lower limb ischemia.
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