干细胞移植治疗肝硬化的临床研究  

Clinical study of patients with decompensated cirrhosis treated with stem cell transplantation

作　　者：贺莉[1] 乔丽娟[1] 曾维政[1] 蒋明德[1] 

机构地区：[1]成都军区总医院消化内科,成都610083

出　　处：《中华细胞与干细胞杂志（电子版）》2015年第1期37-41,共5页Chinese Journal of Cell and Stem Cell（Electronic Edition）

摘　　要：目的观察外周血干细胞及脐带血干细胞移植治疗肝硬化的临床疗效。方法选取2009年8月至2010年6月期间在成都军区总医院消化内科行干细胞治疗的失代偿期肝硬化患者34例,对患者进行自身对照的临床研究,外周血干细胞移植14例,脐带血干细胞移植20例,并比较两种干细胞治疗肝硬化的疗效。将干细胞通过肝动脉途径植入患者肝脏内,于移植后2周、4周、8周进行肝功能、凝血指标检测,并于4周及8周行腹部B超及胃镜检查,观察患者移植后不同时间症状改善情况及术后不良反应的发生情况。对移植术后生化指标的改变,采用非参数Firedman检验及t检验进行统计学分析。结果 34例接受干细胞移植的肝硬化患者术中术后无明显不良反应发生。移植后,患者临床症状改善明显,食欲不振、乏力、腹水等减轻甚至消失;血清学检测:术后8周,外周血干细胞治疗组白蛋白水平由术前(30.35±5.44)g/L升至(35.86±4.75)g/L(P<0.05);凝血酶原时间由术前(13.97±1.50)s降至(12.61±1.20)s(P<0.05);总胆红素由术前(52.18±29.46)μmol/L下降至(37.96±20.25)μmol/L(P<0.05);脐带血干细胞治疗组白蛋白水平由术前(29.43±5.35)g/L升至(34.92±3.79)g/L(P<0.05);凝血酶原时间由术前(14.89±1.77)s降至(14.21±2.00)s(P<0.05);总胆红素由术前(52.72±38.06)μmol/L降至(46.25±32.21)μmol/L(P<0.05)。外周血干细胞治疗组与脐带血干细胞治疗组相比,差异无统计学意义。结论干细胞移植治疗失代偿期肝硬化是一种安全、有效的方法,尤其是在提高白蛋白水平及改善凝血功能方面有很好的疗效,可作为肝移植治疗的过渡或补充治疗。Objective To investigate the clinical therapeutic effect of peripheral blood stem cells transplantation and umbilical blood stem cells transplantation on patients with liver cirrhosis. Methods A total of 34 patients with cirrhosis were enrolled. Peripheral blood stem cell transplantation was performed in 14 cases, and umbilical cord blood stem cell transplantation in 20 cases. The efficacy were compared between the 2 groups. Stem cells were transplanted into patient＇s liver through hepatic arteries. At 2, 4 and 8 weeks after transplantation, liver function and coagulation index tests were performed. Abdominal ultrasound and endoscope examination were performed at 4 and 8 weeksn. Changes and adverse reactions in the 34 patients were observed. The statistical analysis for biochemstry was non parameter Firedman test and T test. Results No remarkable side effect was observed in all 34 patients. Their clinical symptoms, such as poor appetite, physical weakness, and peritoneal dropsy were either relieved or entirely disappeared. At 8 weeks after the peripheral blood stem cell transplantation, albumin levels increased from （30.35 ± 5.44） g/L to （35.86 ± 4.75 ） g/L （P 〈 0.05 ）, prothrombin time decreased from （ 13.97 ±1.50） s to （ 12.61 ± 1.20） s （P 〈 0.05）, and total bilirubin decreased from （52.18 ± 29.46） μmol/L to （37.96 ± 20.25） μmol/L （P 〈 0.05）. At 8 weeks after umbilical cord blood stem cell transplantation, albumin levels increased from （29.43 ±5.35） g/L to （34.92 ±3.79） g/L （P 〈 0.05）, prothrombin time decreased from （14.89 ± 1.77） s to （14.21 ± 2.00） s （P 〈 0.05）, and total bilirubin decreased from （52.72 ± 38.06） μmol/L to （46.25 ± 32.21 ） μmol/L （P 〈 0.05 ）. There was not significant statistical difference between the peripheral blood stem cell group and the umbilical cord blood stem cell group. Coneluslons Stem cells transplantation is a safe and effective therapy for hepatocirrhosis. Albumin levels and liv

关 键 词：外周血干细胞 脐血干细胞 肝硬化 

分 类 号：R575.2[医药卫生—消化系统]