骨髓单个核细胞移植对不同Child-Pugh分级肝硬化血清胆碱酯酶的影响  

Effect of autologous bone marrow mononuclear cells transplantation on serum cholinesterase in patients with liver cirrhosis of different Child-Pugh scores

作　　者：王帅[1] 姚鹏[1] 龚丽娟[1] 闻炜[1] 李树玲[1] 胡学玲[1] 胡大荣[1] 

机构地区：[1]北京军区总医院肝病治疗中心,100700

出　　处：《肝脏》2009年第3期189-193,共5页Chinese Hepatology

摘　　要：目的探讨肝动脉插管自体骨髓单个核细胞移植对不同Child-Pugh分级肝硬化患者血清胆碱酯酶(CHE)的影响。方法201例肝硬化患者,其中131例行自体骨髓单个核细胞移植,70例为对照。骨髓穿刺采集自体骨髓,体外分离纯化骨髓单个核细胞,经肝动脉插管将其移植入肝脏。分别于移植后4、8、12、24周观察血清CHE变化情况,比较不同Child-Pugh分级肝硬化患者CHE改变,并观察患者并发症发生情况。结果移植组患者移植前血清CHE为2 387.4U/L,移植后4周、8周、12周和24周分别升至2 875.9U/L、3 190.6U/L、3 216.0U/L和3 066.5U/L。患者移植后24周内血清CHE水平较移植前显著升高,而对照组无明显升高,两组比较差异有统计学意义。移植组中,Child-Pugh A级和B级患者血清CHE改善程度优于C级患者。两组患者24周内主要并发症发生率差异无统计学意义。移植后无严重不良事件发生。结论自体骨髓单个核细胞移植能提高肝硬化患者血清CHE水平,对Child-Pugh A级和B级患者改善明显。Objective To investigate the effect of autologous bone marrow mononuclear cells （BM-MNCs） transplantation in patients with liver cirrhosis of different Child-Pugh scores. Methods 201 patients with liver cirrhosis were investigated. Autologous BM-MNCs transplantation was carried on 131 of these patients, and the left 70 patients were compared as control group. Their bone marrow was aspirated and BM-MNCs were isolated by density grads centrifuge. About （5.51 ± 2.63） × 10^8 mononuclear cells were infused to patients by intubatton through hepatic artery. The serum cholinesterase（CHE） were detected at different time after transplantation（after 4,8,12 and 24 weeks） and were compared with their Child-Pugh scores. Meanwhile symptoms, complications and prognosis of these patients were recorded. Results Before transplantation of BM-MNCs, the mean serum CHE value of transplantation group was 2 387.4 U/L. The value rised to 2 875.9 U/L,3 190.6 U/L,3 216.0 U/L and 3 066.5 U/L at 4,8,12 and 24 weeks after transplantation respectivoly. Serum CHE values of patients in transplantation group were higher than that of control group. In transplantation group,the improvement of serum CHE were more significant in Child-pugh A and B patients than that in Child-Pugh C patients. No severe adverse reaction was found in the patients with autologous BM MNCs transplantation. Conclusion Autologous BM-MNCs transplantation can improve the CHE values in patients with liver cirrhosis and significant benefited for Child-Pugh A and B patients.

关 键 词：骨髓单个核细胞 移植 肝硬化 胆碱酯酶 

分 类 号：R575.2[医药卫生—消化系统]