自体外周血干细胞移植治疗乙型肝炎肝硬化患者疗效及安全性分析  

Efficacy and safety of autologous peripheral blood stem cell transplantation in patients with hepatitis B cirrhosis

作　　者：赵芳芳 翟永贞[1] 冯国和[1] Zhao Fangfang;Zhai Yongzhen;Feng Guohe(Department of Infectious Disease,Shengjing Hospital,China Medical University,Shenyang 110021,Liaoning Province,China)

机构地区：[1]中国医科大学附属盛京医院感染病科

出　　处：《实用肝脏病杂志》2019年第5期700-703,共4页Journal of Practical Hepatology

摘　　要：目的临床可用于治疗失代偿期乙型肝炎肝硬化患者的有效措施有限,且效果多不理想。干细胞移植是一个理想的选择。本研究的目的是评估自体外周血干细胞移植(APBSCT)治疗乙型肝炎肝硬化患者的疗效和安全性。方法在100例乙型肝炎肝硬化患者中,对照组50例接受常规治疗,在另50例,先接受重组人粒细胞集落刺激因子(rhG-CSF)注射动员,然后分离和采集外周血干细胞,并通过介入方法注入肝固有动脉。观察6 m。结果在干细胞移植后1 m,移植组和对照组患者血清TBIL水平分别为(34.5±17.2)μmol/L和(59.3±12.8)μmol/L(P<0.05),ALB分别为(35.3±3.2)g/L和(30.2±1.5)g/L(P<0.05),差异显著;术后6 m,血清ALB水平分别为(30.6±4.4)g/L和(27.6±1.9)g/L(P<0.05),Child-Pugh评分分别为(8.4±2.1)分和(9.7±3.3)分(P<0.05),差异显著。结论应用APBSCT治疗乙型肝炎肝硬化患者安全,近期有效,但对预后的影响还需要观察。Objective Currently,an available options for treatment of decompensated hepatitis B-induced liver cirrhosis are limited.Recently,stem cell transplantation has emerged as a promising alternative in this setting.The aim of this study was to evaluate the efficacy and safety of autologous peripheral blood stem cell transplantation(APBSCT)in patients with hepatitis B cirrhosis.Methods A total of 100 patients with hepatitis B-induced liver cirrhosis(LC)were devided into transplantation and control group,and 50 patients in control group were treated with conventional therapies,and other 50 patients in transplantation group were mobilized by injection of recombinant human granulocyte colony stimulating factor(rhG-CGF),the peripheral blood stem cells were separated and collected and then the stem cells were injected directly into the proper hepatic artery.A six-month follow-up survey was conducted in all the patients.Results One month after the APBSCT,the main indexes of liver functions in the transplantation group improved as compared with those before operation,and serum bilirubin levels in transplantation group and control group were(34.5±17.2)μmol/L and(59.3±12.8)μmol/L,respectively,significantly different(P<0.05),and serum albumin levels were(35.3±3.2)g/L and(30.2±1.5)g/L,significantly different(P<0.05);at the end of six month transplantation,serum albumin levels were(30.6±4.4)g/L and(27.6±1.9)g/L,and Child-Pugh scores were(8.4±2.1)and(9.7±3.3),respectively,significantly different(P<0.05).Conclusions Autologous peripheral blood stem cells transplantation for patients with LC is a safe and feasible procedure,which might improve the liver functions and life quality at short-term observation.

关 键 词：肝硬化 自体外周血干细胞移植 治疗 

分 类 号：R73[医药卫生—肿瘤]