宫内膜干细胞治疗失代偿期乙型肝炎肝硬化疗效的初步探讨  

Clinical effectiveness of endometrial stem cell transplantation in treating patients with hepatitis B virusrelated decompensated liver cirrhosis

作　　者：张金龙[1] 项春生 刘芙蓉[1] 黄志刚[1] 莫国生[1] 揭中华[1] 陈锦阳 

机构地区：[1]武警浙江省总队医院传染科,浙江嘉兴314000 [2]杭州易文赛生物技术有限公司,浙江杭州311121

出　　处：《中国病原生物学杂志》2014年第9期838-841,共4页Journal of Pathogen Biology

摘　　要：目的探讨宫内膜干细胞移植治疗失代偿期乙肝肝硬化患者的临床疗效。方法选择乙肝肝硬化失代偿期患者43例,随机分成两组,其中对照组30例,采用拉米夫定、阿德福韦酯抗病毒治疗;实验组13例,在对照组治疗基础上加用宫内膜干细胞治疗。分别在治疗后1、6、12个月检查各组患者肝脏功能、甲胎蛋白、胆碱酯酶、肝纤维化、凝血酶原时间,观察病毒学应答、临床症状及不良反应情况。结果治疗后1、6、12个月,实验组患者ALT、AST、TBIL、ALB、肝纤维化系列(LN、HA、PC-Ⅲ、Ⅳ)、CHE、PT等指标较对照组明显改善(ALT:F实验组=11.432,F对照组=8.231;AST:F实验组=13.197,F对照组=9.732;TBIL:F实验组=10.964,F对照组=8.692;Alb:F实验组=2.846,F对照组=3.691;CHE:F实验组=67.428,F对照组=70.285;LN:F实验组=20.462,F对照组=16.390;HA:F实验组=30.421,F对照组=23.521;PCⅢ:F实验组=23.532,F对照组=17.397;IV:F实验组=20.386,F对照组=15.496;PT:F实验组=1.752,F对照组=0.950。P均<0.05);治疗后12个月实验组和对照组HBVDNA阴转率和HBeAg血清转换率均较治疗后6月显著增加,且实验组显著优于对照组(P<0.05);两组患者治疗前后临床症状和体征均有所改善,治疗期间均未发现严重不良反应。结论采用宫内膜干细胞治疗乙肝肝硬化失代偿期患者,肝脏功能及临床症状明显改善,病毒应答率高,短期观察安全可靠,不良反应小,提高了患者的生活质量,值得临床进一步研究。Objective To study the clinical effectiveness of endometrial stem cell transplantation in treating patients with hepatitis B virus-related decompensated liver cirrhosis. Methods Subjects were 43 patients with hepatitis B virusrelated decompensated liver cirrhosis,and patients were randomly divided into two groups,a control group of 30 patients receiving lamivudine and adefovir dipivoxil and a treatment group of 11 patients receiving the same treatment plus endometrial stem cell therapy.One,6,and 12 months after treatment,the 2groups of patients were examined to determine their liver function,AFP levels,cholinesterase levels,prothrombin time,liver fibrosis,and other laboratory indexes and to observe their virological response,clinical symptoms,and adverse reactions. Results One,6,and 12 months after treatment,patients in the treatment group had significantly improved ALT,AST,TBIL,and ALB levels,significantly improved levels of liver fibrosis indicators（LN,HA,PC-III,and C-IV）,and significantly improved CHE levels and PT in comparison to the control group（P〈0.05）（ALT：FExperimental group=11.432,FControl group=8.231;AST：FExperimental group=13.197,FControl group=9.732;TBIL：FExperimental group=10.964,FControl group=8.692;Alb：FExperimental group=2.846,FControl group=3.691;CHE：FExperimental group=67.428,FControl group=70.285;LN：FExperimental group=20.462,FControl group=16.390;HA：FExperimental group=30.421,FControl group=23.521;PC-III：FExperimental group=23.532,FControl group=17.397;C-IV：FExperimental group=20.386,FControl group=15.496;and PT：FExperimental group=1.752,FControl group=0.950.P〈0.05）;Twelve months after treatment,both the treatment group and the control group had a marked increase in negativity for HBV DNA and HBeAg seroconversion than they did 6months after treatment.The treatment group had a higher rate of negativity for HBV DNA and HBeAg seroconversion than did the control group（P）.Clinical symptoms and physical indicators improved for both groups of patients,and no s

关 键 词：干细胞移植 肝炎 乙型 肝硬化 拉米夫定 阿德福韦酯 

分 类 号：R373.21[医药卫生—病原生物学]