骨髓间充质干细胞对肝豆状核变性合并肝纤维化肝功能的临床研究  

Clinical research about liver function of hepatolenticular degeneration combined liver fibrosis by transplantation of bone marrow stem cells

作　　者：张东锋[1] 王煜姝[1] 滕军放[2] 

机构地区：[1]郑州人民医院,郑州450003 [2]郑州大学第一附属医院,郑州450052

出　　处：《中国免疫学杂志》2016年第2期193-196,200,共5页Chinese Journal of Immunology

基　　金：郑州市科技计划项目(121PPTGG494-1)

摘　　要：目的:探讨骨髓间充质干细胞(Bone marrow mesenchymal stem cells,BMSCs)治疗对肝豆状核变性肝纤维化患者肝功能及其血清学指标的影响。方法:将60例确诊肝豆状核变性肝纤维化患者随机分为:青霉胺组、BMSCs组和BMSCs+青霉胺组。无菌条件下进行骨髓干细胞采集、分离、鉴定。青霉胺组:口服青霉胺(每日40 mg/kg),12周;BMSCs组:将骨髓间充质干细胞液2 ml+生理盐水100 ml经外周静脉移入人体,10 d 1次,3次为一个疗程;BMSCs+青霉胺组:青霉胺(40 mg/kg)口服,12周,同时经外周静脉输入BMSCs,方法同上。分别于治疗0、4、8、12周检测血总胆红素(total bilirubin,TBIL)、丙氨酸氨基转移酶(Alanine aminotransferase,ALT)、白蛋白(Albumin,ALB)、胆碱酯酶活力(Cholinesterase,CHE)、血小板衍生生长因子-BB(Platelet-derived growth factor-BB,PDGF-BB)、转化生长因子β1(Transforming growth factor-β1,TGF-β1)、白介素-6(Interleukin-6,IL-6)、肿瘤坏死因子α(Tumor necrosis factorα,TNF-α)的含量,并做组间比较,分别于治疗前后做肝组织病理活检。结果:BMSCs+青霉胺组肝组织活检肝纤维化整体改善较其他两组明显;各组TBIL、ALT、ALB、CHE、PDGF-BB、TGF-β1、IL-6和TNF-α均持续降低,但BMSCs+青霉胺组中肝功能改善和细胞因子的降低比其他组更明显,差异具有统计学意义(P<0.05)。结论:BMSCs联合青霉胺治疗对肝豆状核变性合并肝纤维化肝功能有明显改善。Objective： To evaluate the influence of bone marrow stem cells （BMSCs） in the serological indicators of hepatolenticular degeneration combined liver fibrosis. Methods： 60 cases were randomly divided into 3 groups： penieillamine group, BMSCs group and BMSCs＋penicillamine group. BMSCs（2 ml）were injected into vein with normal saline（ 100 ml） every 10 days （ 3 times for a period of treatment）. Liver tissue pathology biopsy was inspected and TBIL, ALT, ALB, CHE, PDGF-BB, TGF-β1, IL-6 and TNF-a were detected at 0,4,8 and 12 weeks. Results： The level of serological indicators about liver functions were reduced in every group, while the changes in BMSCs ＋ penicillamine group were especially obvious （P〈 0. 05 ）. Conclusion： Penicillamine combined with BMSCs was effective in the improvement of liver functions of hepatolenticular degeneration combined liver fibrosis.

关 键 词：肝豆状核变性 肝功能 骨髓间充质干细胞 青霉胺 

分 类 号：R742.4[医药卫生—神经病学与精神病学]