脐血干细胞移植对失代偿期肝硬化肝功能及血流动力学的影响  

Effect of liver volume and liver hemodynamics of human umbilical cord blood stem cell transplantation on decompensated cirrhosis

作　　者：王可敬[1] 罗晓红[1] 孙厚坦[1] 王方[1] 包建涛[1] 

机构地区：[1]兰州军区总医院内分泌科,730070

出　　处：《疑难病杂志》2014年第11期1126-1129,1133,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：甘肃省自然科学基金项目(No.1208RJZA062)

摘　　要：目的观察脐血干细胞移植治疗失代偿期肝硬化的疗效及对肝血流动力学的影响。方法选择失代偿期肝硬化患者30例为治疗组,经肝固有动脉进行异体人脐血干细胞移植;选择资料匹配的同期住院未行脐血干细胞输注的失代偿期肝硬化患者20例作为对照组。比较2组患者肝功能、凝血功能、门静脉血流动力学、B型超声肝脏体积及造影剂消退时间等指标,并观察患者临床症状改善情况及不良反应。结果治疗组肝内脐血干细胞移植成功率为100%,无不良反应和并发症发生。与治疗前比较,2组治疗后3、6个月谷氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、白蛋白(Alb)均有改善(P<0.05),且治疗组Alb改善优于对照组(P<0.05);与治疗前比较,治疗组治疗3、6个月总胆红素(TBil)明显降低,对照组治疗6个月时降低(P<0.05);治疗组治疗1、3、6个月后甲胎蛋白(AFP)明显增加,且与对照组同时点比较差异有统计学意义(Jp<0.05)。与移植前比较,治疗组凝血酶原时间(PT)于移植后3、6个月显著下降(P<0.05),与对照组比较差异显著(P<0.05);纤维蛋白原(Fib)在移植后3、6个月显著增加(P<0.05),与对照组比较差异不显著(P>0.05)。凝血活酶时间(APTT)和凝血时间(TT)在移植后均呈降低趋势,但与移植前差异不显著,对照组亦无明显变化(P>0.05)。与治疗前比较,2组门静脉内径(DPV)、脾静脉内径(DSV)、门静脉最大流速(PVX)、脾静脉最大流速(SVV)、门静脉血流量(QPV)、脾静脉血流量(QSV)差异均无统计学意义(P>0.05)。治疗后,2组肝脏体积均有增大趋势.但比较差异均无统计学意义(P>0.05)。与治疗前比较,脐血干细胞移植后,治疗组造影剂消退时间明显减慢(P<0.05),与对照组比较差异有统计学意义(P<0.05)。结论经肝固有动脉行脐血干细胞移植治疗失代偿期肝硬化可以改善肝功能及静脉血流情况,且安全有效,为临床肝病的治疗探索了Objective To observe the therapeutic effect of umbilical cord blood stem cells transplantation in the treat -ment of decompensated cirrhosis of the liver and the effects on liver hemodynamics.Methods 30 cases of patients with de-compensated liver cirrhosis as treatment group , underwent the proper hepatic artery allogeneic umbilical cord blood stem cell transplantation;chosen the data matched 20 cases of patients with decompensated cirrhosis who did not receive the injection of umbilical cord blood stem cells treatment as the control group.Liver function , coagulation function , hemodynamics of portal vein, B ultrasound contrast agent was compared between the 2 groups of patients.The time of the liver volume and other indi-cators, the clinical symptoms and adverse reaction were observed.Results The success rate of intrahepatic umbilical cord blood stem cell transplantation was 100%in the treatment group , no adverse reaction and complication were occurre. Com-pared with before treatment, after the treatment in the 2 groups, 3, 6 months of glutamate aminotransferase （ALT）, aspartate aminotransferase （AST）, albumin （Alb） were improved （ P 〈0.05）, and the Alb in the treatment group was better than the control group （ P 〈0.05 ）; and compared with before treatment , in the treatment group , 3, 6 months of total bilirubin （TBil） decreased significantly, control group reduces at 6 months after treatment （ P 〈0.05）;in treatment group, 1, 3, 6 months later , AFP significantly increased , compared with the control group at the same time , the difference was statistically significant（ P 〈0.05.Compared with the treatment group before transplantation ,prothrombin time（PT）after transplantation in 3, 6 months was significantly decreased （ P 〈0 .05）, the difference was significant compared with control group （ P 〈0.05）;fibrinogen （Fib） in 3, 6 months after transplantation was significantly increased （ P 〈0.05）, compared with the control group, the difference was not

关 键 词：脐血干细胞 肝硬化 失代偿期 血流动力学 

分 类 号：R575.2[医药卫生—消化系统]