脐带血干细胞对慢乙肝失代偿期肝硬化的临床疗效  

Effect of umbilical cord blood stem cells for the treatment of decompensated cirrhosis in patients with chronic hepatitis B

作　　者：王丽华[1] 陈玉梅[1] 李炳茂[2] 孙建顺[1] 杨彬[1] 张丽贤[1] Wang Lihua Chen Yumei Li Bingmao Sun Jianshun Yang Bin Zhang Lixian(Department of Gastroenterology Department of Traditional Chinese Medicine, Harrison International Peace Hospital, Hengshui 053000, China)

机构地区：[1]哈励逊国际和平医院消化内科,衡水053000 [2]哈励逊国际和平医院中医科,衡水053000

出　　处：《中华细胞与干细胞杂志（电子版）》2016年第5期292-296,共5页Chinese Journal of Cell and Stem Cell（Electronic Edition）

基　　金：河北省中医药管理局科研基金项目(2012234)

摘　　要：目的观察经肝动脉注入脐带血干细胞治疗慢乙肝肝硬化的临床疗效。方法纳入60例慢乙肝肝硬化失代偿期患者，经肝动脉注入脐带血干细胞（2～6）×10^7，观察治疗后1周、4周、12周、20周肝功能[白蛋白（ALB）、总胆红素（TBIL）、谷丙转氨酶（ALT）、谷草转氨酶（AST）、凝血酶原活动度（PTA）]水平变化；检测第20周血清肝纤维化指标[层粘连蛋白（LN）、透明质酸（HA）、Ⅲ型前胶原PC-Ⅲ、Ⅳ型胶原Ⅳ-C]改善情况，上述两种指标采用配对t检验，同时观察临床症状（食欲、精力、体力情况）及体征（水肿、腹水情况）的改善情况。结果全部病人均顺利完成治疗，治疗后未出现严重不良反应及并发症；治疗12周时多半患者食欲、精力、体力改善至正常水平，双下肢浮肿、腹腔积液等体征消失，治疗后1周血ALT、AST较治疗前增高（t=2．289，2．603；P=0．026，0．012）、ALB较治疗前降低（t=2．352，P=0．022），TBIL较治疗前略高（t=1．985，P=0．052），PTA较治疗前略低（t=1．924，P=0.059），但差别无统计学意义（P〉0．05）；治疗后4周ALT、AST、ALB、PTA、TBIL均恢复至治疗前水平；治疗后12周ALT、AST（t=2．259，P=0．028）较治疗前降低（t=2．565，2．259；P=0．013，0．028），PTA较治疗前升高（t=2．572，P=0．013），ALB较治疗前明显改善（t=20．04，P〈0．001），TBIL较治疗前略低（t=1．962，P=0．055），无统计学意义（P〉0．05）；20周后各项指标ALT、AST、ALB、PTA、TBIL及肝纤四项均改善（t=10．13，8．652，26．686，6．385，4．194，P均〈0．001）。结论经肝动脉注入脐带血干细胞治疗慢乙肝肝硬化近期有效。Objective To evaluate the clinical efficacy of umbilical cord blood stem cell therapy on decompensated cirrhosis in patients with chronic hepatitis B. Methods 60 chronic hepatitis B patients with dccompensated cirrhosis were enrolled. The umbilical cord blood stem cells [ （2 - 6） × 10^7] were injected into liver by hepatic artery. To evaluate the clinical efficacy, albumin, total bilirubin, alanine aminotransferase, aspartate aminotransferase and prothrombin activity after 1,4,12,20 weeks were observed. Serum Fibrosis Indexes （laminin LN, Hyaluronic acid HA, Ⅲ procollagen PC- Ⅲ and Ⅳ collagen Ⅳ -C） after 20 weeks and clinical symptoms were evaluated. Results No patients reported severe postoperative complications and adverse reactions. The spirit, strength and appetite of most patients returned to normal at 12 week. Edema and ascites disappeared. After one week of treatment, ALT, AST increased and serum albumin levels decreased （ P 〈 0.05）, while TBIL slightly increased and PTA slightly decreased （ P 〉 0. 05）. ALT, AST, ALB, PTA and TBIL returned to the levels of pretreatment, after four weeks of treatment. After twelve weeks of treatment, ALT, AST decreased（ P 〈 0.05）, Serum albumin levels improved greatly （P 〈 0.01 ）, and PTA increased too（ P 〈 0.05）, while TBIL slightly decreased（P 〉 0.05）. All serum biochemical index improved at twenty weeks after treatment, （P 〈 0.05）. Conclusion Umbilical cord blood stem cells are safe and effective for decompensated cirrhosis in patients with chronic hepatitis B.

关 键 词：脐血干细胞 肝硬化 肝炎 乙型 慢性 

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