脐带间充质干细胞移植对失代偿期乙型肝炎肝硬化患者免疫功能和转归的影响  

Effect of umbilical cord mesenchymal stem cell transplantation on immune function and prognosis of patients with decompensated hepatitis B cirrhosis

作　　者：方雪晴[1] 张骏飞 宋海燕 陈照林 董静 陈曦 潘劲劲 刘波 陈从新[1] 

机构地区：[1]安徽医科大学附属解放军临床学院,合肥230001 [2]解放军第一零五医院感染病科,合肥230001

出　　处：《中华肝脏病杂志》2016年第12期907-910,共4页Chinese Journal of Hepatology

摘　　要：目的探讨人脐带间充质干细胞（hUCMSCs）对失代偿期乙型肝炎肝硬化患者免疫功能及转归的影响。方法65例失代偿期乙型肝炎肝硬化患者，分为观察组和对照组，观察组采用介入（经肝固有动脉或门静脉）和静脉灌注途径将制备的4×10^8hUCMSCs分2次输入患者体内，其余基础治疗同对照组，对照组进行内科常规治疗。采用酶联免疫吸附法检测观察组术前、术后1周血清白细胞介素（IL）-6、肿瘤坏死因子（TNF）α、IL-10、转换生长因子（TGF）D水平与对照组人院时、人院1周后血清IL-6、TNFα、IL—10、TGFD水平;使用流式细胞仪测定观察组术前、术后1周与对照组入院时、入院1周后淋巴细胞亚群百分比；另外，观察住院期间两组患者转归情况和主要并发症，并随访24周观察两组患者死亡数。计量资料用t检验，计数资料以百分率表示，用x^2检验。结果与对照组相比，观察组在移植hUCMSCs后1周血清IL-6、TNFα水平明显下降，血清IL-10、TGFβ水平明显上升（P值均〈0．001），T4细胞、Treg细胞明显升高，T8细胞、B淋巴细胞明显降低（P值均〈0．05），T3细胞和自然杀伤细胞变化差异无统计学意义（P〉0．05）；观察组住院期间患者病情进展至肝衰竭的概率（6．45％）较对照组（14．71％）更低，差异有统计学意义（P=0．017）。结论UCMSCs移植治疗失代偿期肝硬化患者时，可能通过抑制T、B淋巴细胞的增殖和T8细胞分化，而上调Treg细胞，促进抑制性细胞因子分泌，减少炎性细胞因子产生，从而减轻肝脏炎症反应和肝细胞的破坏，降低肝衰竭发生概率。Objective To investigate the effect of human umbilical cord mesenchymal stem cells （hUCMSCs） on the immune function and prognosis of patients with decompensated hepatitis B cirrhosis. Methods A total of 65 patients with decompensated hepatitis B cirrhosis were divided into observation group and control group. The patients in the observation group were given intervention （via the proper hepatic artery or the portal vein） and intravenous infusion of 4× 10^8 hUCMSCs in two doses, as well as the same basic treatment as in the control group. The patients in the control group were given conventional medical treatment. ELISA as used to measure the serum levels of interleukin-6 （IL-6）, tumor necrosis factor-α （TNFα）, interleukin-10 （IL-10）, and transforming growth factor-β （TGFβ） in the observation group before surgery and at 1 week after surgery, as well as the serum levels of IL-6, TNFα, IL-10, and TGFβ in the control group on admission and at 1 week after admission. Flow cytometry was used to measure the percentage of lymphocyte subsets in the observation group before surgery and at 1 week after surgery, as well as that in the control group on admission and at 1 week after admission. In addition, the patients＇ prognosis and major complications during hospitalization were observed in both groups, and the patients were followed up for 24 weeks to record the number of deaths. The t-test was used for comparison of continuous data, and the chi-square test was used for comparison of categorical data which were expressed as percentages. Results At 1 week after the transplantation of hUCMSCs, compared with the control group, the observation group had significant reductions in the serum levels of IL-6 and TNFa and significant increases in the serum levels oflL-10 and TGFβ （allP 〈 0.001）, as well as significant increases in the percentages of T4 cells and Treg cells and significant reductions in the percentages of T8 cells and B cells （all P 〈 0.05）. There were no significant differ

关 键 词：肝硬化  间质干细胞 细胞因子类 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学]