人脐带间充质干细胞治疗慢加急性肝衰竭患者的初步临床观察  

A pilot study of human umbilical cord derived-mesenchymal stem cells transfusion in patients with acute-on-chronic liver failure

作　　者：李元元[1] 徐若男[1] 施明[1] 林沪[1] 王立峰[1] 吕飒[1] 陈黎明[1] 张政[1] 王福生[1] 

机构地区：[1]解放军第三〇二医院生物治疗研究中心,北京100039

出　　处：《中华细胞与干细胞杂志（电子版）》2015年第1期32-36,共5页Chinese Journal of Cell and Stem Cell（Electronic Edition）

基　　金：国家"863课题"(2013AA020102)

摘　　要：目的评价人脐带间充质干细胞(UC-MSC)治疗慢加急性肝衰竭患者的安全性及初步临床效果。方法采用平行对照、单盲法将解放军第三〇二医院肝病生物治疗研究中心2009年至2013年收治的58例慢加急性肝衰竭患者进行分组,其中31例为治疗组,以外周静脉回输方式接受UC-MSC治疗;27例为对照组,给予生理盐水处理,两组均同时行综合内科治疗。通过卡方检验、Mann-Whitney U检验检测回输后不同时间点治疗组与对照组ALB、TBIL、PTA及MELD评分情况,并随访48周,通过Kaplan-Meier分析曲线评估患者的生存情况。结果 UC-MSC回输后,除个别患者体温有自限性升高外,无其他不良反应。慢加急性肝衰竭患者接受UC-MSC回输48周后,与对照组相比ALB、TBIL、PTA及MELD评分差异无统计学意义(P>0.05),但治疗组生存率明显高于对照组(P=0.013)。随访48周时,治疗组中生存人数21例,死亡7例,肝移植3例;对照组中生存人数11例,死亡15例,肝移植1例。结论 UC-MSC治疗慢加急性肝衰竭患者安全性好,能显著提高患者生存率。Objective To evaluate the safety and therapeutic efficiency of human umbilical cord derived-mesenchymal stem cells （UC-MSC） transfusion in patients with acute- on-chronic liver failure. Methods UC-MSC were identified by morphology, surface markers and differentiation potential. Then UC-MSC were transfused into patients with acute-on-chronic liver failure via vein. Serum ALB, TBIL, PTA and MELD scores were evaluated at different time points after UC-MSC transfusion. All patients were followed up for 48 weeks. Results During the follow-up of 48 weeks, 21 patients were still alive in UC-MSC group, 7 died, and 3 received liver transplantation; In the control group, 11 patients were still alive, 15 died, and 1 received liver transplantation. Beside low-grade fever in few patients, no other side effects were observed. Although ALB, TBIL, PTA levels and MELD scores have not significantly differences between the two groups at 48 weeks after UC-MSC transfusion, survival rate was higher in the UC-MSC group as compared with the control group. Conclusion UC-MSC transfusion was safe and effective in patients with acute-on-chronic liver failure.

关 键 词：间充质干细胞 肝功能衰竭 急性 肝炎病毒 乙型 

分 类 号：R575.3[医药卫生—消化系统]