人脐带间充质干细胞治疗肝硬化腹水患者的前瞻性对照临床疗效观察  

Evaluation on the efficacy of human umbilical cord derived-mesenchymal stem cell transplantation in liver cirrhosis patients with ascites in a prospective and control trial

作　　者：林沪[1] 张政[1] 施明[1] 徐若男[1] 福军亮[1] 李元元[1] 于双杰[1] 陈黎明[1] 吕飒[1] 王福生[1] 

机构地区：[1]解放军第三0二医院肝病生物治疗研究中心,北京100039

出　　处：《中华传染病杂志》2012年第4期204-208,共5页Chinese Journal of Infectious Diseases

基　　金：国家传染病重大专项资助项目（2009ZXIO004-309,2008ZX10002-007）

摘　　要：目的评价人脐带间充质干细胞（UC—MSC）治疗失代偿性肝硬化腹水患者随访1年的临床疗效。方法采用前瞻性、对照、单盲方法，将解放军第三0二医院肝病生物治疗研究中心收治的54例肝硬化腹水患者分为治疗组38例和对照组16例，分别接受UC—MSC（0．5～1．0）×10^6／kg和0．9％氯化钠溶液静脉回输，每月1次，共3次。检测并比较不同时间点两组患者的肝功能、HBVDNA、腹部B型超声检测下腹部腹水变化、终末期肝病评分模型（MELD）。组间比较采用非参数Mann—WhitneyU检验，回输前后数据比较采用Wilcoxon符号秩和检验。结果UC-MSC回输后，两组间不同时间点ALT、TBil、胆碱酯酶、HBVDNA阳性率以及MELD评分比较，差异均无统计学意义（均P〉0．05）；但治疗组患者在回输36周以后血Alb显著升高，治疗前为（28．47±4．45）g／L，48周为（34．82±4．50）g／L（P=0．046）；下腹腹水量显著减少，治疗前为（46．6±30．6）mm，48周为（6．6±13．6）mm，随访结束时与相应对照组比较，均差异有统计学意义（P=0．037）。结论人UC—MSC静脉回输治疗肝硬化腹水患者能升高Alb水平，减少腹水生成，具有良好的临床应用前景。Objective To evaluate the one-year follow-up of the therapeutic efficacy of human umbilical cord derived-mesenchymal stem cell （UC-MSC） transplantations in decompensated liver cirrhosis patients with ascites. Methods Fifty-four liver cirrhosis patients with ascites in Research Center for Biological Therapy in 302 Military Hospital were divided into treatment group （n= 38） and control group （n= 16） in a prospective controlled single-blinded trial. UC-MSC （0.5-1.0） × 106/kg and saline were intravenously transplanted into patients monthly for 3 times in treatment group and control group, respectively. The liver function, hepatitis B virus （HBV） DNA level, ascites and the model for end-stage liver disease（MELD）scores at different time points were compared between two groups. The comparison between groups was done by Mann-Whitney U test, and the data before and after transplantations were compared by Wilcoxon signed rank sum test. Results There were no significant differences of alanine transaminase （ALT） , total bilirubin （TBil）, cholinesterase （CHE）, HBV DNA positive rate and MELD scores at different time points between two groups （P〈0.05）.However, the albumin （Alb） level was significantly increased after 36 weeks of UC-MSC transplantation in treatment group, which were （28.47±4.45） g/L at week 0 and （34.82±4.50） g/L at week 48 （P = 0. 046）. Meanwhile, the ascites reduced markedly in treatment group with （46. 6 ± 30.6） mm at week 0 and （6.6±13.6） mm at week 48, which were significantly different from control group at the end of follow-up （P = 0. 037）. Conclusion UC-MSC transplantations may help to increase Alb level and reduce aseites in patients with decompensated liver cirrhosis.

关 键 词：肝硬化 脐血干细胞移植 腹水 

分 类 号：R575.2[医药卫生—消化系统]