人脐带间充质干细胞肝内移植联合苦参素治疗失代偿期乙型肝炎肝硬化患者疗效与转归分析

doi:10.3969/j.issn.1672-5069.2018.03.011

摘要/Abstract

摘要： 目的探讨人脐带间充质干细胞（UC-MSCs）联合苦参素治疗失代偿期乙型肝炎肝硬化患者的疗效。方法采用随机数字表法将68例失代偿期乙型肝炎肝硬化患者分为对照组34例和观察组34例,分别给予经肝动脉行UC-MSCs移植或在UC-MSCs移植后给予苦参素口服治疗,观察12个月。结果在治疗期间,观察组3例死亡,对照组4例死亡;在治疗12月末,观察组血清ALT为（39.3±15.6） U/L、TBIL为（26.3±10.2） μmol/L,均显著低于对照组【（71.2±17.2） U/L和（39.2±11.2） μmol/L,P<0.05】;血清层粘连蛋白为（81.2±24.1） ng/ml,透明质酸为（135.7±48.5） ng/ml,Ⅳ型胶原为（106.3±32.1） ng/ml,Ⅲ型前胶原为（98.7±25.6） ng/ml,均显著低于对照组【（113.3±29.6） ng/ml、（174.8±51.2） ng/ml、（158.4±35.6） ng/ml、（124.2±30.3） ng/ml,P<0.05】;外周血CD4+细胞百分比为（34.0±4.6）%,CD4+/CD8+比值为（1.2±0.6）,均显著高于对照组【（29.3±4.1）%和（0.9±0.6）,P<0.05】,CD8+为（26.5±4.9）%,显著低于对照组【（31.2±3.9）%,P<0.05】;肝移植和肝癌发生率分别为2.9%和5.9%,与对照组的5.9%和11.8%比较无显著性差异（P>0.05）。结论 HU-MSCs肝内移植联合苦参素胶囊口服治疗失代偿期肝硬化患者可明显减轻肝纤维化,改善肝功能。

关键词: 失代偿期肝硬化, 间充质干细胞, 苦参素, 移植, 预后

Abstract: Objective To investigate the efficacy of intrahepatic transplantation of human umbilical cord mesenchymal stem cells （UC-MSCs） combined with matrine in the treatment of patients with decompensated hepatitis B cirrhosis. Methods A total of 68 patients with decompensated hepatitis B cirrhosis were divided into the control and observation group by randomized number generated by computer,with 34 patients in each group. The patients in control group received intrahepatic UC-MSCs transplantation,and those in observation group received matrine orally after UC-MSCs transplantation. Serum laminin （LN）,hyaluronic acid （HA）,type IV collagen （IV-C）,and type III procollagen （PC III）] and peripheral blood T lymphocyte subset were detected before and after 12 months of treatment. Results During the follow-up,3 patients in the observation group and 4 patients in the control group died;at the end of 12 months of treatment,serum ALT and TBIL levels in observation group were（39.3±15.6） U/L and（26.3±10.2） μmol/L,significantly lower than（71.2±17.2） U/L and （39.2±11.2） μmol/L in the control group（P<0.05）;serum levels of LN,HA,IV-C and PC III in the observation group were（81.2±24.1） ng/ml,（135.7±48.5） ng/ml,（106.3±32.1） ng/ml and（98.7±25.6） ng/ml,much lower than（113.3±29.6） ng/ml,（174.8±51.2） ng/ml,（158.4±35.6） ng/ml and（124.2±30.3） ng/ml in the control group（P<0.05）;the percentage of peripheral blood CD4+ cells and the ratio of CD4+/CD8+ cells in the observation group were（34.0±4.6） % and （1.2±0.6）,much higher than（29.3±4.1） % and（0.9±0.6） in the control group,while CD8+ cells was（26.5±4.9） %,much lower than（31.2±3.9） % in the control group（P<0.05）;there were no significant difference as respect to the incidence of liver transplantation or liver cancer between the two group（2.9% and 5.9%,vs. 5.9% and 11.8%,respectively,P>0.05）. Conclusion HU-MSCs transplantation and matrine could obviously relieve liver fibrosis,and improve liver function in patients with decompensated liver cirrhosis.

Key words: Decompensated liver cirrhosis, Mesenchymal stem cells, Transplantation, Prognosis

赵宇, 祝瑜, 张代忠. 人脐带间充质干细胞肝内移植联合苦参素治疗失代偿期乙型肝炎肝硬化患者疗效与转归分析[J]. 实用肝脏病杂志, 2018, 21(3): 360-363.

Zhao Yu, Zhu Yu, Zhang Daizhong. Efficacy of intrahepatic transplantation of human umbilical cord mesenchymal stem cells combined with matrine in the treatment of patients with decompensated hepatitis B cirrhosis[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2018, 21(3): 360-363.

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