自体骨髓间充质干细胞培养后经肝动脉介入治疗失代偿期肝硬化1例  

Transplantation of autologous bone marrow mesenchymal stem cells after culture via hepatic artery for one patient with decompensated cirrhosis

作　　者：焦红亮[1,2] 杨波[1] 关方霞[3] 李建斌[2] 詹三华 杜英[5] 胡祥 迟连凯[3] 梁硕[3] 史辛艺[3] 

机构地区：[1]郑州大学第一附属医院神经外科,河南省郑州市450052 [2]河南省红十字血液中心,河南省郑州市450014 [3]郑州大学生物医学工程学,河南省郑州市450052 [4]河南省武警总队医院普内科,河南省郑州市450052 [5]郑州大学基础医学院微生物与免疫学教研室,河南省郑州市450052 [6]深圳市北科生物科技有限公司,广东省深圳市518000

出　　处：《中国组织工程研究与临床康复》2010年第45期8535-8538,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：郑州大学211工程三期重点学科建设项目;河南省医学科技创新人才工程项目(2005018)~~

摘　　要：背景:骨髓间充质干细胞在特定环境下可分化成肝干细胞及肝细胞,从而参与肝结构和功能的修复和重构。目的:进一步验证自体骨髓间充质干细胞培养后经肝动脉介入治疗肝硬化的安全性、可行性及疗效。方法:1例肝硬化患者进行自体骨髓单个核细胞移植,骨穿采集自体骨髓体外分离纯化骨髓单个核细胞。骨髓单核细胞培养4d后经肝动脉插管将其移植入肝脏。移植后4周观察血清白蛋白、胆碱酯酶、凝血酶原活动度、总胆红素、谷丙转氨酶、谷草转氨酶、凝血酶原时间、纤维蛋白原变化情况,观察患者并发症及预后。结果与结论:培养后骨髓间充质干细胞数量明显增多,患者移植前后各项指标变化情况:移植前血清白蛋白、胆碱酯酶、凝血酶原活动度、谷丙转氨酶、谷草转氨酶、凝血酶原时间、纤维蛋白原分别为29.43g/L,2378.5U/L,47.4%,112.78U/L,79.36U/L,17.91s,2.01g/L。移植后4周分别为33.30g/L,2866.5U/L,55.8%,79.01U/L,56.37U/L,16.26s,2.35g/L。移植后无严重不良事件发生。结果表明,自体骨髓间充质干细胞移培养后植治疗可使失代偿期肝硬化患者肝功能明显改善,治疗安全有效且不良反应小,可作为中晚期肝硬化患者的临床治疗方案。BACKGROUND：Bone marrow mesenchymal stem cells（BMSCs） in a specific environment can divide into hepatic stem cells and liver cells,which can participate in repair and reconstruction of liver structure and function.OBJECTIVE：To explore the safety,feasibility and therapeutic effect of autologous BMSCs after culture transplantation via hepatic artery in treatment of cirrhosis.METHODS：One patient with cirrhosis received autologous bone marrow mononuclear cell transplantation.Bone marrow mononuclear cells were isolated from autologous bone marrow and purified in vitro,and then cultured after 4 days.The stem cells were transplanted into the liver via hepatic artery.At 4 week after transplantation,serum albumin（ALB）,cholinesterase（CHE）,prothrombin activity（PTA）,total bilirubin level（TBil）,alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,prothrombin time（PT）,fibrinogen changes and complications and prognosis were observed.RESULTS AND CONCLUSION：Numbers of BMSCs were significantly increased after culture.The index changes were respectively observed before and after transplantation.Pre-transplant：ALB,CHE,PTA,ALT,AST,PT,and fibrinogen were respectively 29.43 g/L,2 378.5 U/L,47.4%,112.78 U/L,79.36 U/L,17.91 s,2.01 g/L;4 week after transplantation：33.30 g/L,2 866.5 U/L,55.8%,79.01U/L,56.37 U/L,16.26 s,and 2.35 g/L.No adverse event occurred following transplantation.Results suggest that after transplantation of autologous bone marrow,the liver function of patients was significantly improved.This method was safe and effective in the treatment of patients with decompensated cirrhosis.It can be used as a clinical treatment in patients with middle and advanced stage cirrhosis.

关 键 词：骨髓 间充质干细胞 肝硬化 培养 

分 类 号：R394.2[医药卫生—医学遗传学]