脐带间充质干细胞移植治疗慢性肝衰竭  

Therapeutic effect of human umbilical cord mesenchymal stem cells transplantation in the treatment of chronic liver failure

作　　者：张岁[1] 柳立平[1] 马文波[1] 贾蓓[1] 王海舫[1] 解从君[1] 

机构地区：[1]河北医科大学第一医院中西医结合肝病诊疗中心,河北省石家庄市050031

出　　处：《中国组织工程研究》2017年第13期2056-2061,共6页Chinese Journal of Tissue Engineering Research

基　　金：河北省医学科学研究重点课题(20150636)~~

摘　　要：背景:脐带间充质干细胞来源丰富,取材方便,增殖能力强,可以分化为肝细胞,为肝衰竭治疗开辟了新途径。目的:观察脐带间充质干细胞移植治疗慢性肝衰竭的安全性和疗效。方法:慢性肝衰竭患者50例,按平行对照分组方式分为2组:干细胞组25例,在内科综合治疗的基础上给予脐带间充质干细胞移植,经前臂静脉途径输注脐带间充质干细胞(1.4-2.3)×106/kg,总体积100 mL,对照组25例,给予单纯内科综合治疗,输注等体积的生理盐水,每半个月1次,共输注3次。于治疗前、治疗后2,4,12,24周观察患者的肝功能、凝血酶原活动度、MELD评分、临床症状、生存情况及不良反应。结果与结论:(1)干细胞组白蛋白、凝血酶原活动度在治疗后12,24周较对照组明显升高,差异有显著性意义(P<0.05);MELD评分在治疗后4,12,24周较对照组明显降低,差异有显著性意义(P<0.05);(2)两组丙氨酸转氨酶、总胆红素比较差异无显著性意义(P>0.05);(3)治疗4周后,干细胞组临床症状明显改善,与对照组比较差异有显著性意义(P<0.05);(4)随访24周,干细胞组生存率高于对照组,差异有显著性意义(P<0.05);(5)未出现与干细胞治疗相关的不良反应,无肝癌发生;(6)结果表明,脐带间充质干细胞移植治疗慢性肝衰竭患者安全有效,可明显提高患者生存率。BACKGROUND：Umbilical cord mesenchymal stem cells are plentifully and conveniently obtained with a high proliferative ability, and have opened up a new way to treat patients with liver failure as they can differentiate into hepatocyte-like cells.OBJECTIVE：To observe the safety and efficacy in the treatment of chronic liver failure by transplanting umbilical cord mesenchymal stem cells.METHODS：Using parallel contrast method, 50 patients with chronic liver failure were divided into two groups, namely a stem cell group and a control group, containing 25 patients in each group. For the first group, transplantation of umbilical cord mesenchymal stem cells, （1.4-2.3）×10^6/kg, 100 mL, was given on the basis of medical comprehensive treatment,while for the second group only simple medical comprehensive treatment was given. The injection was done every 15 days, totally three times. Liver functions, prothrombin activity, Model for End-Stage Liver Disease （MELD） score, clinical symptoms, survival and side effects of the patients were observed before and 2, 4, 12 and 24 weeks after the treatment.RESULTS AND CONCLUSION：Compared with the control group, the albumin level and prothrombin activity were significantly increased in the stem cell group 12 and 24 weeks after treatment （P 〈 0.05）, while the MELD score was significantly decreased in the stem cell group at 4, 12 and 24 weeks after treatment （P 〈 0.05）. There was no significant difference in alanine aminotransferase and total bilirubin levels between the two groups （P 〉 0.05）. Four weeks after treatment, clinical symptoms of the stem cell group improved significantly in comparison with the control group （P 〈 0.05）.During the 24-week follow-up, the survival rate in the stem cell group was significantly higher than that in the control group （P 〈 0.05）. Additionally, there were no adverse reactions and liver cancer associated with the stem cell therapy.Results show that it is safe and effective to treat patients with chronic live

关 键 词：干细胞 移植 脐带间充质干细胞 慢性肝衰竭 乙型肝炎病毒 肝功能 凝血酶原活动度 MELD评分 安全性 

分 类 号：R394.2[医药卫生—医学遗传学]