重型肝炎的自体骨髓干细胞肝内移植治疗评估  

Evaluation of transplantation of autologous bone marrow-derived stem cells in patients with severe hepatitis

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

机构地区：[1]北京军区总医院,北京100700

出　　处：《传染病信息》2009年第5期288-290,共3页Infectious Disease Information

摘　　要：目的明确自体骨髓干细胞移植对肝脏疾病的治疗作用,为重型肝炎的临床治疗提供新方法。方法选择我院肝病治疗中心的慢性重型肝炎住院患者120例,年龄20～60岁。80例行自体骨髓干细胞移植,40例为对照。患者在无菌条件下,抽取骨髓100ml,分离纯化骨髓干细胞。在局部麻醉下,分离的骨髓干细胞经肝动脉移植肝脏。对患者在移植后的1、2、4、8、12、24周进行肝功能检测,观察患者移植后症状改善情况及术后的不良反应。结果患者在移植后24周内,ALT逐渐降低,由平均183.2U/L降至98.3U/L;TBIL逐渐降低,由平均151.3μmol/L降至81.3μmol/L;ALB逐渐升高,由平均26.1g/L升至32.5g/L;PTA逐渐上升,由平均43.8%升到60.2%;患者生存率有所提高;此外,移植后大多数患者症状有明显改善。结论自体骨髓干细胞移植治疗后,患者肝功能改善,症状好转,生存率有所提高;自体骨髓干细胞移植治疗不良反应小,安全。Objective To explore the effect of transplantation of autologous bone marrow-derived stem cells （BMSCs） for patients with liver diseases so as to find a new approach to the treatment of severe hepatitis. Methods Totally 120 patients with chronic severe hepa- titis from liver diseases center of our hospital, aged 20-60 were enrolled. Eighty patients received transplantation of autologous BMSCs, and 40 were taken as controls, Under non-sterile condition, 100 ml of bone marrow was harvested from the patients in the transplant group, and then BMSCs were isolated and purified. Under local anesthesia, isolated BMSCs were infused into the livers of the patients via hepatic artery. At week 1, 2, 4, 8, 12, 24 after transplantation, ALT, TBIL, ALB and PTA were detected, and the improvement of symptoms and ad- verse reactions were observed after transplantation. Results Within 24 weeks after transplantation, ALT levels reduced gradually from 183.2 U/L to 98.3 U/L on average, TBIL levels from 151.3 μmol/L to 81.3 μmol/L on average, ALB levels increased gradually from 26.1 g/L to 32.5 g/L on average and PTA from 43.8% to 60.2% on average. The survival rate of the transplant group was higher than that of the control group. The symptoms of the patients in the transplant group were markedly improved. Conclusions The liver function and symptoms of the patients with severe hepatitis are improved, and the survival rate increases after transplantation of autologous BMSCs. The approach is safe with fewer adverse reactions.

关 键 词：骨髓干细胞 移植 重型肝炎 

分 类 号：R457.7[医药卫生—治疗学]