自体骨髓干细胞移植术治疗终末期肝硬化患者疗效观察  

Autologous bone marrow mesenchymal stem cell transplantation can improve the liver function of patients with decompensated cirrhosis caused by hepatitis B

作　　者：毛华[1] 金少琴[1] 黄纯炽[1] 唐银丽[1] 谢玥[1] 

机构地区：[1]南方医科大学附属珠江医院消化科,广州510280

出　　处：《中华临床医师杂志（电子版）》2013年第8期44-47,共4页Chinese Journal of Clinicians(Electronic Edition)

基　　金：广东省科技项目(2009B030801212)

摘　　要：目的探讨自体骨髓干细胞经肝动脉移植治疗乙型肝炎肝硬化失代偿期的安全性、可行性及疗效。方法本研究纳入了64例乙型肝炎肝硬化失代偿期的患者,其中32例患者接受了自体骨髓干细胞移植治疗,同时选取与移植组在年龄、性别以及某些生化指标[包括丙氨酸氨基转移酶(ALT),白蛋白(ALB),总胆红素(TBIL),凝血酶原时间(PT)]相匹配的32例患者作为对照组。采集骨髓150～250ml,分离纯化骨髓干细胞,经肝动脉插管植入肝脏,观察植入治疗术前及术后第1周到第4周主要肝功能指标及临床症状的变化、不良反应。结果 32例患者骨髓干细胞的采集、分离以及灌注均顺利,成功率为100%。术后未观察到严重的不良反应或并发症。与对照组相比,移植组在术后第1～4周ALT、TBIL、ALB、PT水平无显著性差异(P>0.05);当患者Child-Pugh分级均为ChildA+B级时,移植组患者在术后第1～4周肝功能指标的变化较对照组有所改善,但差异无统计学意义(P>0.05);当患者Child-Pugh分级均为ChildC级时,两组ALT水平仍无显著性差异(P>0.05),而从移植术后第3～4周时,移植组中ALB、PT和TBIL水平较对照组有显著改善(P<0.05)。结论经肝动脉自体骨髓干细胞移植术治疗乙型肝炎肝硬化失代偿期安全有效,短期内即可改善肝功能ChildC级患者的临床症状和体征,从而使患者生存质量得到较大提高,具有推广价值。Objective To investigate the efficacy of liver failure patients caused by hepatitis B after a single transplantation with autologous marrow mesenchymal stem cells （MMSCs）. Methods A total of 64 inpatients with liver failure caused by hepatitis B were recruited and received the same medical treatments, among whom 32 patients underwent a single transplantation with autologous MMSCs. A total of 32 patients matched for age, sex, and biochemical indexes, including alanine aminotransferase （ ALT）, albumin, total bilirubin （ TBIL）, prothrombin time （PT） ,comprised the control group. A total of 150-250 ml of bone marrow was obtained from each patient and then diluted and separated. Then, the MMSC suspension was slowly transfused into the liver through the proper hepatic artery. Results The success rate of transplantation was 100% ,without serious side effects or complications. There were no significant differences in levels of ALT, ALB,TBIL, and PT of patients between transplantation group and control group. And the results were similar in Child-Pugh A ＋ B patients. However,in Child-Pugh C patients,levels of ALB, TBIL, and PT were markedly improved from 3-4 weeks after transplantation, compared with those in the control group. Conclusions Autologous MMSC transplantation has markedly improved liver function and generally well- being of Child-Pugh C patients. This method is safe and effective for liver failure patients caused by chronic hepatitis B.

关 键 词：骨髓祖代细胞 干细胞移植 肝硬化 

分 类 号：R575.2[医药卫生—消化系统]