人脐带间充质干细胞治疗慢加急性乙肝肝衰竭的安全性及临床效果  

The safety and therapeutic efficacy evaluation for human umbilical cord mesenchymal stem cells transplantation in patients with acute-onchronic liver failure caused by hepatitis B virus

作　　者：何宏亮[1] 许文雄[2,3] 王培培[2,3] 李建国[2,3] 邓洪[2,3] 高志良[2,3] 

机构地区：[1]安徽医科大学附属省立医院感染病科,安徽合肥230001 [2]中山大学附属第三医院感染性疾病科,广东广州510630 [3]广东省肝脏疾病研究重点实验室,广东广州510630

出　　处：《热带医学杂志》2015年第12期1625-1628,共4页Journal of Tropical Medicine

基　　金：国家十二五"艾滋病和病毒性肝炎等重大传染病防治"科技重大专项(2012ZX10002004)

摘　　要：目的探讨人脐带间充质干细胞(UCˉMSCs)治疗慢加急性乙肝肝衰竭(HBVˉACLF)的安全性及临床应用效果。方法选择2012年8月至2013年5月于中山大学附属第三医院感染性疾病科住院的HBVˉACLF 100例,以内科综合治疗联合UCˉMSCs移植作为治疗组(n=46),内科综合治疗为对照组(n=54),随访12周,观察治疗组的不良反应和两组患者治疗前后的主观症状、凝血功能、肝肾功能和终末期肝病模型(MELD)评分的变化情况。结果治疗组46例患者均移植成功,其中15例有一过性低热;与对照组相比,治疗组治疗后1、2周的乏力、纳差、腹胀等主观症状的改善好于对照组,在第4周的时候,乏力减轻40例(86.9%),纳差好转38例(82.6%),腹胀好转35例(55.6%),改善更为明显(P<0.05)。在随访的4、8、12周,ALT和Cr下降的差异无统计学意义,ALB从第8周开始明显升高(P<0.05);TBil和PTA在随访第4和12周的改善差异有统计学意义(P<0.05);MELD评分从第8周开始显著下降(P<0.05)。结论UCˉMSCs治疗HBVˉACLF具有良好的安全性,能改善短期内患者的肝功能、凝血功能等客观指标,提高生活质量。Objective To investigate the safety and therapeutic efficacy of human umbilical cord mesenchymal stem cells（UCˉMSCs）transplantation in acuteˉonˉchronic liver failure patients associated with hepatitis B virus infection（HBVˉACLF）. Methods A total of 100 HBV-ACLF patients were recruited and divided into two groups： 46 patients were treated with UCˉMSCs transplantation（UCˉMSCs group）and 54 patients only received standard medical treatment（control group）.UCˉMSCs therapy was given four times at 4ˉweek intervals. During the 12ˉweek followˉup period, primary outcome measures such as adverse reactions（including body temperature,tetter and allergy）were observed. Secondary outcome measures were evaluated as follows： biochemical indexes such as alanine aminotransferas（ALT）,albumin（ALB）,total bilirubin（TBil）,prothrombin activity（PTA）, creatinine（Cr）,clinical symptom including debilitation,appetite,abdominal distension and MELD scores. Results Fever was observed in 15 cases, no serious adverse reactions and complications occurred after UC-MSCs transplantation. At the first and second week after treatment,the symptoms such as appetite,debilitation,and abdominal distension were improved in UCˉMSCs group, especially at the end of fourth week,debilitation improved in 40 cases（86.9 %）,appetite improved in 38 cases（82.6%）,abdominal distension improved in 35 cases（55.6 %）（P0.05）. Compared with the control group,ALT and Cr were not significantly decreased during the 12ˉweek followˉup period,ALB and MELD scores were significantly improved from 8 weeks,TBil and PTA had significant improvements at the eighth and twelfth week after UC-MSCs transfusions. Conclusions The transplantation of UCˉMSCs are safe and can improve clinical symptoms,liver function,MELD scores and so on. Therefore UCˉMSCs may be a new therapeutic method for HBVˉACLF.

关 键 词：脐带 间充质干细胞 肝衰竭 乙型肝炎 移植 

分 类 号：R575.3[医药卫生—消化系统]