肝动脉超选灌注自体骨髓干细胞治疗失代偿期乙型肝炎肝硬化的临床研究  

Treatment with superselective hepatic artery infusion of autologous bone marrow stem cells in patients with HBV-related decompensated cirrhosis

作　　者：金波[1] 孟繁平[1] 冯宇[1] 文凤[1] 贾雪红[1] 马雪梅[1] 张敏[2] 高银杰[2] 向轶[2] 汤汝佳[2] 王华明[3] 马威[3] 李捍卫[1] 王慧芬[4] 

机构地区：[1]解放军第三○二医院肝硬化诊疗中心,北京100039 [2]解放军第三○二医院肝移植研究中心,北京100039 [3]解放军第三○二医院医学影像中心,北京100039 [4]解放军第三○二医院肝衰竭诊疗与研究中心,北京100039

出　　处：《传染病信息》2011年第3期143-146,共4页Infectious Disease Information

基　　金：国家"十一五"科技重大专项(2008ZX10002-005-6)

摘　　要：目的分析肝动脉超选灌注自体骨髓干细胞对失代偿期乙型肝炎(乙肝)肝硬化患者的疗效及安全性。方法选择失代偿期乙肝肝硬化患者20例,从髂后上棘抽取骨髓,体外分离纯化骨髓源性干细胞,通过肝动脉超选注入肝脏,在移植后2、4、8、12周复查肝功能,观察实验室指标变化及不良反应情况。同时选取常规治疗的失代偿期乙肝肝硬化患者20例作为对照。结果治疗组PTA水平自治疗第2周起即出现明显上升,与治疗前比较,差异有统计学意义(P<0.05)。血清ALB从治疗第2周即开始升高,与治疗前比较,差异有统计学意义(P<0.01),且上升趋势在治疗12周时仍存在。随访结束时,治疗组ALB水平从(26.55±3.24)g/L上升至(31.54±4.2)g/L。CHE水平治疗前后比较差异有统计学意义(P<0.05)。TBIL在治疗后逐步下降,至第12周时下降更为明显(P<0.05)。未发生与干细胞移植相关的并发症。结论经肝动脉超选自体骨髓干细胞灌注治疗失代偿期乙肝肝硬化安全、有效。Objective To analyze the efficacy and safety of treatment with superselective hepatic artery infusion of autologous bone marrow stem cells （BMSC） in patients with HBV-related decompensated cirrhosis. Methods Bone marrow was aspirated from poster superior spine of 20 adult patients with HBV-related decompensated cirrhosis （BMSC treatment group）. After isolation and purification in vitro, the stem cells were injected into liver via hepatic artery. The liver function parameters, laboratory parameters and side effects were observed in 2, 4, 8 and 12 weeks after infusion. Another 20 patients with HBV-related decompensated cirrhosis receiving routine therapy were included as the controls （control group）. Results The level of prothrombin time activity in the BMSC treatment group obviously increased at week 2 after the infusion of autologous BMSC, and compared with pretherapy, the difference was significant （P〈0.05）. The level of serum albumin （ALB） in the BMSC treatment group began to increase at week 2 after the infusion, and compared with pretherapy, the difference was significant （P〈0.01）. ALB level kept increasing at week 12 and it increased from （26.55＋3.24） g/L to （31.54-＋4.2） g/L after 12 weeks of follow-up. CHE level in the BMSC treatment group was significantly different between pre-and post-therapy （P〈0.05）. After the infusion of autologous BMSC, TBIL level decreased gradually, and it was significantly different at week 12 after infusion （P〈0.05）. No complications related to stem cell transplantation were found. Conclusions Superselective hepatic artery infusion of autologous BMSC is safe and effective in treatment of patients with HBV-related decompensated cirrhosis.

关 键 词：骨髓干细胞 肝动脉超选 肝硬化 

分 类 号：R512.61[医药卫生—内科学] R457.7[医药卫生—临床医学]