自体骨髓间充质干细胞治疗失代偿期酒精性肝硬化疗效分析*

doi:10.3969/j.issn.1672-5069.2015.06.016

摘要/Abstract

摘要： 目的探讨骨髓间充质干细胞（BMSCs）移植治疗失代偿期酒精性肝硬化（ALC）患者的疗效。方法2007年至2012年在我院行BMSCs移植治疗的失代偿期ALC患者28例,给予基础治疗联合BMSCs移植治疗;按照性别、年龄和并发症进行1:1倾向性评分匹配选择另28例患者为对照,只接受基础治疗。常规检测血肝功能指标,使用计算机断层扫描和DSA造影进行影像学检查。结果接受细胞移植治疗的患者在移植后谷丙转氨酶下降,总胆红素降低,白蛋白逐渐升高,凝血酶原时间及Child-Pugh评分逐渐下降,终末期肝病模型评分于移植后第4周降至（20.6±5.2）分,显著低于移植前的（26.4±5.1）分（P<0.05）,也显著低于对照组的（24.7±5.1）分（P=0.009）,但至第72周时移植组为（17.5±4.1）分,与对照组的（18.9±6.9）分相比,无显著性差异（P=0.536）;两组144周生存率分别为32.1% 和25.6%,无显著性差异（P=0.125）;进行分层分析结果显示,Child-Pugh B级患者在细胞移植144周生存率为66.7%,显著高于对照组的36.4%（P=0.046）,而两组Child-Pugh C级患者生存率分别为12.5%和 17.6%,无显著性差异（P=0.788）。结论BMSCs移植治疗失代偿期ALC患者的近期疗效显著,但远期疗效不显著。移植前患者病情可能影响移植后疗效,但此结论有待更大样本,多中心的随机对照试验来证实。

关键词: 酒精性肝硬化, 骨髓间充质干细胞, 移植, 疗效

Abstract: Objective To investigate the efficacy of intrahepatic transplantation of autologous bone marrow mesenchymal stem cells （BMSCs） in the treatment of patients with decompensated alcohol-induced liver cirrhosis （ALC）. Methods Twenty-eight patients with decompensated alcohol-induced liver cirrhosis were recruited for intrahepatic transplantation of BMSCs from 2007 to 2012,and other 28 patients with ALC were selected by propensity scores matching for age,gender and complications of liver cirrhosis. Results The serum alanine aminotransferase levels declined to nearly normal levels,total bilirubin decreased,albumin（ALB） increased, prothrombin times shorten,and Child-Pugh scores（CPS） were improved gradually;The model of end stage liver disease scores were significant decreased to（20.6±5.2） at forth week,and significantly lower than in the control group（P=0.009）,however,there was no remarkable differences after 72 weeks （P=0.536） between the two groups;The survival rates at 144 weeks in the two groups were not significantly different （32.1% vs. 25.6%,P=0.125）;Further analysis showed that the survival rates in patients with CPS class B in the two groups were significantly different （66.7% vs. 36.4%,P=0.046）,while there was no significant difference in patients with CPS class C （12.5% vs. 17.6%,P=0.788）. Conclusions The short-term efficacy of BMSCs transplantation in the treatment of patients with decompensated ALC is favorable,but the long-term efficacy needs further investigation.

Key words: Alcohol-induced liver cirrhosis, Autologous bone marrow mesenchymal stem cells, Transplantation, Efficacy

沈建坤，郑联坵，潘兴南，赖江琼. 自体骨髓间充质干细胞治疗失代偿期酒精性肝硬化疗效分析^*[J]. 实用肝脏病杂志, 2015, 18(6): 628-632.

Shen Jiankun， Zheng Lianqiu， Pan Xingnan， et al.. Efficacy of intrahepatic transplantation of autologous bone marrow mesenchymal stem cells in the treatment of patients with decompensated alcohol-induced liver cirrhosis[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2015, 18(6): 628-632.

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自体骨髓间充质干细胞治疗失代偿期酒精性肝硬化疗效分析^*

Efficacy of intrahepatic transplantation of autologous bone marrow mesenchymal stem cells in the treatment of patients with decompensated alcohol-induced liver cirrhosis

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