脐血干细胞移植治疗失代偿期乙型肝炎肝硬化的临床研究  

Clinical Research on Umbilical Cord Blood Stem Cells Transplantation for Hepatitis B Liver Cirrhosis at Discompensation Stage

作　　者：周晓玲[1] 谢胜[1] 侯秋科[1] 李灿[1] 

机构地区：[1]广西省柳州市中医院脾胃病科,柳州545001

出　　处：《成都医学院学报》2013年第5期571-574,共4页Journal of Chengdu Medical College

基　　金：广西科技攻关项目(NO:2012AD09044);中国高校医学期刊临床专项资金项目(NO:11321116)

摘　　要：目的观察经肝动脉行脐血干细胞移植治疗失代偿期乙型肝炎肝硬化患者的临床疗效。方法选择失代偿期乙型肝炎肝硬化患者56例随机分为两组,治疗组30例,体外分离纯化脐血干细胞制成10mL细胞悬液,通过肝动脉介入的方法移植入肝脏,并配合抗病毒及保肝退黄等对症治疗;对照组26例,予抗病毒及保肝退黄等对症治疗。两组患者分别于治疗第2、4、8周评价肝脏功能、凝血功能变化,观察临床症状、体征及不良反应并计算Child-Pugh评分。结果治疗组于干细胞移植术后第2周症状、体征及Child-Pugh评分较术前明显改善,与对照组比较差异有统计学意义(P<0.05);治疗第4周和第8周,血清丙氨酸转氨酶(ALT)、天门冬氨酸转氨酶(AST)、总胆红素(TBil)、直接胆红素(DBil)、凝血酶原时间(PT)较术前均有明显降低;胆碱酯酶(CHE)及白蛋白(Alb)较术前均有明显增高,且与对照组比较差异有统计学意义(P<0.05)。治疗组患者术中均未发生严重并发症。结论脐血干细胞移植治疗失代偿期乙型肝炎肝硬化患者疗效肯定,安全性良好,可作为中晚期肝硬化患者的临床补充治疗手段。Objective To explore the clinical effect of umbilical cord blood stem ceils transplantation via hepatic artery in treatment of hepatitis B liver cirrhosis at discompensation stage. Methods Fifty-six patients with liver cirrhosis at discompensation stage were randomly divided into two groups. Umbilical cord blood stem cells of 30 patients in treatment group were separated to make 10 mL cells suspension in vitro. The liver was transplanted by hepatic arterial intervention, and meanwhile the corresponding treatment like anti-virus and protecting the liver to remove jaundice was also combined. Twenty-six patients in control group were treated with anti-virus treatment and the therapy for protecting the liver to remove jaundice. The liver function and changes of coagulation function in two groups were evaluated at the time of 2,4 and 8 weeks. Clinical symptoms, signs and adverse reactions were observed, and Child-Pugh score was calculated. Results At the time of 2 weeks after stem cells transplantation, the symptoms,signs and Child Pugh score in treatment group were improved obviously compared with prior to surgery, and the difference had statistical significance compared with control group. At the time of 4 and 8 weeks after treatment, serum alanine aminotransferase （ ALT）, aspartate aminotransferase （ AST）, total bilimbin （ TBil）, an direct bilirubin （DBil） and prothrombin time （PT） were significantly decreased compared with prior to surgery, while cholinesterase （CHE） and albumin （Alb） were increased evidently, and the difference had statistical significance. All the patients in treatment group had no severe complications. Conclusion Umbilical cord blood stem cells transplantation in treatment of patients with hepatitis B liver cirrhosis at discompensation stage has an affirmed therapeutic effect and better safety, which can be a clinical supplemented method to treat middle/advanced liver cirrhosis.

关 键 词：脐血干细胞 移植 乙型肝炎肝硬化 失代偿期 

分 类 号：R575.2[医药卫生—消化系统]