自体骨髓源性肝干细胞移植治疗肝炎后肝硬化的临床研究  

Intrahepatic transplantation of in vitro induced autologous bone marrow-derived liver stem cells in patients with posthepatitic cirrhosis

作　　者：秦安成[1] 廖彩仙[1] 王宇[1] 袁杰[1] 黄勇平[1] 廖欣鑫[1] 赖勇强[1] 龚祖元[1] 

机构地区：[1]南方医科大学南方医院肝胆外科,广东广州510515

出　　处：《南方医科大学学报》2010年第3期529-531,共3页Journal of Southern Medical University

基　　金：广州市科技攻关计划项目(2007Z3-E0371)

摘　　要：目的探索自体骨髓源性肝干细胞在体外诱导与扩增后肝内移植治疗肝炎后肝硬化的效果。方法选取2008年6月至2009年4月入住我科的肝炎后肝硬化、门脉高压症,并在我科接受了脾切除、门奇静脉断流术治疗的患者12例。治疗组6例,采集并分离自体骨髓源性肝干细胞,在体外培养诱导与扩增7天后,收集细胞在接受脾切除、门奇静脉断流术中经肝固有动脉注入法将其移植至肝内;对照组6例,以同样方法注入等体积生理盐水。通过术前术后患者肝功能及肝纤维化的指标来评估治疗的效果。结果两组病人的术后均未发现手术并发症,术前的各项检验均无统计学差异,术后治疗组肝功能指标谷丙转氨酶、谷草转氨酶、总胆红素、血浆白蛋白、凝血酶原时间;肝纤维化指标:透明质酸、人III型前胶原,均好转:对照组未见明显变化,治疗组优于对照组(P<0.05)。结论自体骨髓肝干细胞体外培养诱导与扩增后肝内移植是一种安全有效的肝病治疗方法,可以显著改善肝炎后肝硬化患者肝功能及肝纤维化的指标。Objective To evaluate the therapeutic effect of in vitro induced autologous bone marrow-derived liver stem cell transplantation for posthepatitic cirrhosis. Methods Between Jun 2008 and Mar 2009, 12 patients with posthepatitic cirrhosis and portal hypertensive underwent azygousportal disconnection and splenectomy in our department. The patients were then divided into two groups to receive autologous bone marrow-deprived liver stem cell infusion via the hepatic artery after in vitro induction for 7 days （n=6） or saline （n=6）. The therapeutic effects of the operations on the liver functions and liver fibrosis index were evaluated. Results All the patients recovered uneventfully and no side effect of the operation was found. After the operation, the patients receiving bone marrow-deprived liver stem cell infusion showed better hepatic function improvement than those receiving saline infusion （P0.05）. Conclusion Transplantation of in vitro induced autologous bone marrow-derived liver stem cell via the hepatic artery is safe and effective for treatment of posthepatitic cirrhosis.

关 键 词：骨髓源性肝干细胞 培养 扩增 移植 肝炎后肝硬化 

分 类 号：R575.2[医药卫生—消化系统]