自体骨髓干细胞移植治疗肝功能衰竭的临床疗效及安全性观察  

Clinical Efficacy and Safety of Autologous Bone Marrow Stem Cell Transportation in Treating Liver Failure

作　　者：王辉[1] 巫贵成[1] 钟庆[1] 

机构地区：[1]重庆三峡中心医院肝病中心,重庆市404000

出　　处：《中国全科医学》2013年第8期933-935,共3页Chinese General Practice

摘　　要：目的观察自体骨髓干细胞移植治疗肝功能衰竭的临床疗效及安全性。方法选择我院2009年2月—2012年6月收治的肝功能衰竭患者18例,回顾性分析其临床疗效及不良反应、肝功能及凝血功能、死亡情况及并发症情况。结果 (1)14例患者精神状态、食欲改善,体力好转,腹腔积液消失或减轻,15例双下肢水肿消失或减轻,1例治疗2个月后清蛋白水平恢复正常;2例在注射骨髓干细胞悬液时感觉腹部"发热",1例出现头昏。(2)15例患者清蛋白水平呈逐渐上升趋势,其中9例恢复到参考值范围;12例患者凝血酶原时间缩短,2例恢复到参考值范围;5例患者总胆红素水平恢复到参考值范围;丙氨酸氨基转移酶水平无明显变化。(3)6例患者死亡,其中4例并发消化道出血,1例并发肝肾综合征;1例术后3年经影像学诊断为"肝脏肿瘤"。结论自体骨髓干细胞移植治疗肝功能衰竭可改善患者低蛋白血症,短期观察较为安全、有效,远期疗效有限。Objective To observe the clinical efficacy and safety of autologous bone marrow stem cell transplantation(ABMSCT)in treating liver failure.Methods The clinical data such as clinical efficacy,adverse reactions,function of liver,blood coagulation,deaths,and complications were analyzed retrospectively in 18 liver failure patients admitted from February 2009 to June 2012 who underwent ABMSCT.Results Mental status,diet,physical fitness improved,seroperitoneum disappeared or alleviated in 14 patients,edema of both lower extremities disappeared or alleviated in 15,albumin level returned to normal in 1 after 2 months of treatment,and 2 had a feeing of 'abdomen fever' when injected suspension of bone marrow stem cells,1 had dizziness.The level of albumin had a gradually-rising trend in 15 patients,in 9 of whom returned to normal.Prothrombin time was shortened in 12 and returned to reference range in 2.Total bilirubin returned to reference range in 5.No significant changes were noted in alanine aminotransferase level.Six patients died,4 of whom complicated by gastrointestinal bleeding,1 by hepatorenal syndrome.One was diagnosed as 'liver tumors' 3 years after operation.Conclusion ABMSCT can improve hypoproteinemia,safe and effective in short-term observation,but its long-term efficacy is limited.

关 键 词：干细胞 骨髓 干细胞移植 肝功能衰竭 治疗结果 安全 

分 类 号：R575.3[医药卫生—消化系统]