实用肝脏病杂志 ›› 2014, Vol. 17 ›› Issue (4): 356-360.doi: 10.3969/j.issn.1672-5069.2014.04.006

• 肝硬化 • 上一篇    下一篇

经肝动脉自体骨髓或脐带血干细胞移植治疗失代偿期肝硬化患者的安全性和近期疗效比较*

王方, 云升皓, 周新人, 寇俊峰, 蔡国芳, 陈瑞丽, 杨兴坤, 张静, 冯淑贤   

  1. 730070兰州市 兰州军区总医院安宁分院感染病科(王方,云升皓,周新人,寇俊峰,蔡国芳,陈瑞丽,杨兴坤,张静); 妇产科(冯淑娴)
  • 收稿日期:2013-12-30 出版日期:2014-08-30 发布日期:2016-04-11
  • 作者简介:王方,女,44岁,医学博士,主任医师。主要研究方向为慢性肝病的发病机理和治疗学研究。E-mail:kaixin919@163.com
  • 基金资助:
    甘肃省科技支撑计划项目(编号:0708NKCA093)

Safety and short-term efficacy of autologous bone marrow or umbilical cord blood stem cells transplantation through hepatic artery in treatment of patients with decompensated cirrhosis

Wang Fang, Yun Shenghao, Zhou Xinren   

  1. Department of Infectious Diseases,Anning Branch of General Hospital, Lanzhou Military Area Command,Lanzhou 730070,Gansu Province,China
  • Received:2013-12-30 Online:2014-08-30 Published:2016-04-11

摘要: 目的比较经肝动脉途径注入自体骨髓干细胞或脐带血干细胞治疗失代偿期肝硬化患者的安全性,以及对患者肝功能和凝血酶原活动度的近期改善作用。方法选择失代偿期肝硬化患者65例,随机分为骨髓组33例和脐血组32例;骨髓组患者经股动脉插管至肝固有动脉注入自体骨髓干细胞移植治疗,脐血组经同样途径注入脐带血干细胞治疗;治疗后8周检测血清谷丙转氨酶、总胆红素、凝血酶原活动度、白蛋白和甲胎蛋白水平变化,同时观察临床症状的改善情况及术后的不良反应。结果治疗后第3天两组患者乏力、纳差症状均有改善,两组间差异无显著性。治疗后8w,骨髓组和脐血组白蛋白水平分别由(31.0±4.6) g/L 上升至(34.6±7.1)g/L和由(34.6±7.1)g/L上升至(37.8±8.3) g/L,凝血酶原活动度上升由(48.8±13.4)% 上升至(55.5±11.2)% 和由(47.5±12.5)上升至(58.9±14.0)%,但两组间改善程度的差异无显著性;在治疗8w末血清谷丙转氨酶、总胆红素和甲胎蛋白在骨髓组分别为(45.6±12.3) IU/L、(28.1±13.5) μmol/L和(11.3±4.1) μg/L,在脐血组分别为(47.2±11.8) IU/L、(30.7±14.8) μmol/L和(9.8±3.5) μg/L,两组间与基础水平相比改善程度的差异也无显著性。结论自体骨髓干细胞或脐带血干细胞经肝动脉途径移植治疗失代偿期肝硬化患者的近期疗效及安全性均良好,但两种细胞治疗的改善水平无显著差异。

关键词: 肝硬化, 自体骨髓干细胞, 脐带血干细胞, 细胞移植, 疗效

Abstract: Objective To investigate the safety of autologous bone marrow stem cells or umbilical cord blood stem cells transplantation in treatment of patients with decompensated cirrhosis through hepatic artery and the improvement in liver function and prothrombin activity in a short term. Methods Sixty-five patients with decompensated cirrhosis were randomly divided into bone marrow group(33 cases) and umbilicus cord blood group (32 cases);patients in bone marrow group received autologous bone marrow stem cells transplantation through hepatic artery and the umbilicus cord blood group received umbilical cord blood stem cells through the same way;the changes of serum alanine aminotransferase,total bilirubin,prothrombin activity,albumin and alpha-fetoprotein after 8 weeks were determined,and the improvement in symptoms and postoperative adverse reactions were observed. ResultsThree days after cell transplantation,patients in both groups achieved significantly improvement in symptom such as fatigue and anorexia but had no significantly difference between the two groups. At eight weeks post therapy,in patients of bone marrow group and umbilicus group,serum albumin level increased significantly from the baseline of (31.0±4.6) g/L to (34.6±7.1)g/L and(26.6±8.0)g/L to(37.8±8.3)g/L, prothrombin activity from (48.8±13.4) % to (55.5±11.2)% and(47.5±12.5) to(58.9±14.0)%,but the improvement did not differ between the two groups;alanine aminotransferase,total bilirubin and alpha-fetoprotein were(45.6±12.3) IU/L,(28.1±13.5)μmol/L and(11.3±4.1)μg/L respectively in patients of bone marrow group and (47.2±11.8) IU/L,(30.7±14.8) μmol/L and(9.8±35) μg/L respectively in patients of umbilical group at 8 weeks post therapy,but the improvement did not differ between groups. Conclusions It is safe and effective in treatment of patients with decompensated cirrhosis using autologous bone marrow stem cells and umbilical cord blood stem cells transplantation through hepatic artery and no significant difference was observed between the two group.

Key words: Cirrhosis, Autologous bone marrow stem cells, Umbilical cord blood stem cells, Cell transplantation, Efficacy