多次人脐带间充质干细胞移植治疗失代偿期乙型肝炎肝硬化患者临床研究

doi:10.3969/j.issn.1672-5069.2018.05.010

摘要/Abstract

摘要： 目的探讨多次进行人脐带间充质干细胞（HUC-MSCs）肝内移植治疗失代偿期乙型肝炎肝硬化患者的临床疗效。方法在60例乙型肝炎肝硬化患者中,接受单次HUC-MSCs肝内移植治疗20例,接受多次细胞移植治疗20例,另20例对照组接受常规内科治疗。在DSA下,经股动脉插管至肝固有动脉或在超声引导下行肝内门静脉穿刺,注入HUC-MSCs约4×10⁸个,行细胞移植治疗1~3次,随访36个月。结果在随访结束时,多次接受细胞移植治疗组死亡2例,接受单次细胞移植治疗组死亡3例,对照组死亡5例;多次移植组血清TBIL为（19.8±5.6）μmol/L、ALB为（40.6±2.2） g/L、INR为（1.1±1.6）和Child-Pugh评分为（5.3±0.6）,与对照组【（50.2±4.3） μmol/L、（32.4±4.3） g/L、（1.6±1.3）和（8.9±0.5）】比,差异有统计学意义（P<0.05）,与单次移植组【（30.4±8.6） μmol/L、（35.6±4.8） g/L、（1.4±0.9）和（7.0±0.6）】比,差异也有统计学意义（P<0.05）;多次移植组患者肝脏最大平扫面积为（140.2±14.5） cm²、脾脏长度为（145.2±19.3） mm、脾脏厚度为（45.8±9.2）mm,与对照组【（134.3±15.6）cm²、（154.7±20.1） mm、（49.9±8.7） mm】比,差异有统计学意义（P<0.05）。结论多次接受HUC-MSCs移植可有效改善失代偿期乙型肝炎肝硬化患者肝功能,安全性可行,其长期疗效还有待观察。

关键词: 肝硬化, 人脐带间充质干细胞, 细胞移植, 治疗

Abstract: Objective To evaluate the efficacy of intrahepatic human umbilical cord mesenchymal stem cell （HUC-MSCs） transplantation in the treatment of patients with hepatitis B-induced decompensated liver cirrhosis （LC）. Methods60 patients with decompensated hepatitis B LC were recruited in this study,and 20 received intrahepatic HUC-MSCs transplantation for once,20 for two to three times,and another 20 received conventional therapy for control. All patients were followed-up for 36 months. Results During the follow-up period,2 patients in multiple cell transplantation group,3 patients in the single cell transplantation group and 5 patients in the control group died;at the end of 36 month follow-up,serum bilirubin,albumin,international ratio of prothrombin time levels and Child-Pugh score in multiple cell transplantation group were（19.8±5.6） μmol/L,（40.6±2.2） g/L,（1.1±1.6） and （5.5±0.48）,much superior as compared with （50.2±4.3） μmol/L,（32.4±4.3） g/l,（1.6±1.3） and （8.9±0.5） in the control group（P<0.05）,or with （30.4±8.6）μmol/L,（35.6±4.8） g/L,（1.4±0.9） and（7.0±0.6） in patients receiving single cell transplantation（P<0.05）;the maximum liver cross-sectional area was（140.2±14.5） cm²,the spleen length was（145.2±19.3） mm and the spleen thickness was （45.8±9.2） mm in the patients receiving multiple cell transplantation,much superior as compared with （134.3±15.6） cm²,（154.7±20.1） mm and （49.9±8.7） mm in the control（P<0.05）. Conclusion Multiple intrahepatic HUC-MSC transplantation in treatment of patients with decompensated hepatitis B-induced liver cirrhosis might improve liver functions,and the approach is safe and reliable, which worth further investigation.

Key words: Liver cirrhosis, Human umbilical cord mesenchymal stem cells, Cell transplantation, Efficacy

张骏飞, 宋海燕, 陈曦, 潘劲劲, 刘力伟, 陈从新, 刘波. 多次人脐带间充质干细胞移植治疗失代偿期乙型肝炎肝硬化患者临床研究[J]. 实用肝脏病杂志, 2018, 21(5): 693-696.

Zhang Junfei, Song Haiyan, Chen Xi, et al.. Clinical observation of intrahepatic human umbilical cord mesenchymal stem cell transplantation in the treatment of patients with hepatitis B-induced decompensated liver cirrhosis[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2018, 21(5): 693-696.

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