关键词: 肝硬化, 人脐带血单个核细胞, 人脐带间充质干细胞, 治疗

Abstract: Objective The purpose of this study was to investigate the efficacy of human umbilical cord blood mononuclear cells (hUCB-MNCs) and human umbilical cord mesenchymal stem cell (hUC-MSCs) transfusion in patients with hepatitis B liver cirrhosis and its impact on peripheral blood CD4⁺, CD8⁺, CD34⁺ and CD38^- cells. Methods 116 patients with decompensated hepatitis B liver cirrhosis were admitted to our hospital between March 2018 and March 2022, and were divided into control and observation group, with 58 cases in each. The patients in the control group were treated with routine liver-protecting medicines, nutritional support, entecavir for antiviral therapy, and β-blocker, and those in the observation group were treated with intravenous hUCB-MNCs and hUC-MSCs transfusion, once a week, for two to eight weeks, at base of treatment in the control. The percentages of peripheral blood CD4⁺, CD8⁺, CD34⁺ and CD38^- cells were detected by flow cytometry and serum tumor necrosis factor-α (TNF-α), transforming growth factor-β (TGF-β), interleukin-6 (IL-6) and IL-10 levels were detected by ELISA. The liver stiffness measurement (LSM) was detected by FibroScan. Results At the end of eight week treatment, serum albumin level in the observation group was (30.9±3.2)g/L, much higher than [(28.4±2.7)g/L, P＜0.05], while serum bilirubin level was (23.5±5.9)μmol/L, much lower than [(28.4±6.8)μmol/L, P＜0.05] in the control; the percentages of peripheral blood CD4⁺, CD34⁺ and CD38^- cells were (39.8±3.1)%, (7.3±1.9)% and (5.7±1.4)%, all significantly higher than [(36.1±3.9)%, (4.2±1.5)% and (4.6±1.2)%, respectively, P＜0.05], while the percentage of blood CD8⁺ cells was (22.2±2.1)%. significantly lower than [(28.5±2.5)%, P＜0.05] in the control; serum TNF-α and IL-6 levels were (189.3±58.4)ng/L and (102.5±28.6)ng/L, both significantly lower than [(237.9±62.5)ng/L and (135.8±36.2)ng/L, P＜0.05], while serum TGF-β and IL-10 levels were (47.3±7.9)pg/L and (48.6±14.9)pg/L, both significantly higher than [(35.6±5.8)pg/L and (36.9±11.7)pg/L, respectively, P＜0.05] in the control; the Child-Pugh score and LSM were (7.6±1.8) and (8.0±0.2)kPa, both significantly lower than [(8.5±1.7) and (8.8±0.3)kPa, P＜0.05] in the control group. Conclusion The combination transfusion of hUCB-MNCs and hUC-MSCs in the treatment of patients with hepatitis B cirrhosis could improve liver functions, evidenced by increased serum albumin levels, which might be related to the inhibited bogy inflammatory reactions and modulation of immune functions.

Key words: Liver cirrhosis, Human cord blood mononuclear cell, Human umbilical cord mesenchymal stem cells, Therapy