自体骨髓干细胞经肝动脉肝内移植治疗失代偿期乙型肝炎肝硬化患者疗效研究  

Efficacy of transarterial intrahepatic transplantation of autologous bone marrow stem cells in the treatment of patients with decompensated hepatitis B cirrhosis

作　　者：王菁 毕宁[1] 方亮[1] 田园 Wang Jing;Bi Ning;Fang Liang(Department of Gastroenterology,Central Hospital,Huanggang 438000,Hubei Province,China)

机构地区：[1]湖北省黄冈市中心医院消化内科,438000 [2]华中科技大学同济医学院武汉市中心医院内科

出　　处：《实用肝脏病杂志》2021年第6期887-890,共4页Journal of Practical Hepatology

摘　　要：目的探讨自体骨髓干细胞(BMSC)经肝动脉肝内移植治疗失代偿期乙型肝炎肝硬化患者的疗效。方法2015年1月~2020年1月我院收治的失代偿期乙型肝炎肝硬化患者76例,给予所有患者内科综合治疗,研究组在内科综合治疗的基础上进行自体BMSC经肝动脉肝内移植治疗。结果在治疗24 w末,研究组血清总胆红素水平为(17.2±2.3)μmol/L,显著低于对照组【(21.7±2.9)μmol/L,P<0.05】,血清白蛋白和血清前白蛋白水平分别为(31.4±5.8)g/L和(241.4±54.3)mg/l,显著高于对照组【(28.9±5.2)g/L和(197.8±42.7)mg/l,P<0.05】;研究组血清透明质酸、Ⅲ型前胶原和Ⅳ型胶原水平分别为(116.1±42.7)μg/L、(67.1±18.1)μg/L和(92.2±14.9)g/L,显著低于对照组【(163.5±38.8)μg/L、(98.7±21.3)μg/L和(112.8±16.7)g/L,P<0.05】;研究组外周血CD3+和CD4+细胞百分比及CD4+/CD8+比值分别为(67.2±4.3)%、(42.8±1.2)%和(1.5±0.1),显著高于对照组【(60.8±3.3)%、(37.6±4.6)%和(1.4±0.1),P<0.05】;研究组Child-Pugh评分为(7.8±1.7)分,显著低于对照组【(8.8±2.3)分,P<0.05】,MELD评分为(14.3±2.8)分,显著高于对照组【(17.6±2.4)分,P<0.05】。结论采用自体骨髓干细胞经肝动脉肝内移植治疗失代偿期乙型肝炎肝硬化患者可有效改善肝功能,安全,值得临床进一步验证。Objective The aim of this study was to explore the efficacy of transarterial intrahepatic transplantation of autologous bone marrow stem cells( BMSCs) in the treatment of patients with decompensated hepatitis B-induced liver cirrhosis( LC). Methods A total of 76 patients with decompensated hepatitis B-induced LC were enrolled in our hospital between January2015 and January 2020,and 41 patients received transarterial intrahepatic transplantation of BMSCs and all patients were treated by comprehensive internal medical therapy. Results At the end of 24 week treatment,serum bilirubin level in patients receiving BMSC transplantation was( 17.2±2.3) μmol/L,significantly lower than [( 21.7±2.9) μmol/L,P<0.05],while serum albumin and prealbumin levels were( 31.4±5.8) g/L and( 241.4± 54.3) mg/l,significantly higher than [( 28.9± 5.2) g/L and( 197.8± 42.7)mg/l,respectively,P<0.05] in the control;serum hyaluronic acid,type Ⅲ procollagen and type IV collagen levels were( 116.1±42.7) μg/L,( 67.1± 18.1) μg/L and( 92.2± 14.9) g/L,significantly lower than [( 163.5± 38.8) μg/L,( 98.7± 21.3) μg/L and( 112.8±16.7) g/L,respectively,P<0.05]in the control;the percentages of peripheral blood CD3+ cells and CD4+ cells as well as the ratio of CD4+/CD8+ cells were( 67.2±4.3) %,( 42.8±1.2) % and( 1.5±0.1),significantly higher than [( 60.8±3.3) %,( 37.6±4.6) % and( 1.4±0.1),respectively,P<0.05] in the control;the Child-Pugh score was( 7.8±1.7),and the model for endstage liver disease( MELD) score was( 14.3±2.8),both significantly lower than [( 8.8±2.3) and( 17.6±2.4),respectively,P<0.05] in the control. Conclusion Transarterial intrahepatic transplantation of autologous bone marrow stem cells could effectively and safely improve liver functions in patients with decompensated hepatitis B cirrhosis,which is worthy of further clinical verification.

关 键 词：肝硬化 自体骨髓干细胞 经肝动脉肝内移植 治疗 

分 类 号：R575.2[医药卫生—消化系统]