实用肝脏病杂志 ›› 2012, Vol. 15 ›› Issue (3): 247-249.doi: 10.3969/j.issn.1672-5069.2012.03.024

• 病毒性肝炎和肝硬化 • 上一篇    下一篇

骨髓干细胞肝动脉移植治疗失代偿期肝硬化87例*

黄丽雯 刘 黎 周 健   

  1. 430064 武汉市 武汉科技大学附属天佑医院感染性疾病科
  • 出版日期:2016-06-10 发布日期:2016-05-11
  • 通讯作者: 刘黎,E-mail:llgfyy@yahoo.com.cn
  • 作者简介:黄丽雯 女,30岁,硕士研究生,主治医师。主要研究方向:中西医结合诊治肝胆疾病。E-mail:huangliwen1127@163.com
  • 基金资助:
    吴阶平医学基金会肝病医学部肝病实验诊断研究基金资助项目(编号:LDWMF-PJ-2011A001)

Clinical analysis of bone marrow stem cell transplantation by hepatic artery in treatment of 87 patients with decompensated cirrhosis

Huang Liwen,Liu Li,Zhou Jian.   

  1. Department of Infectious Disease,Tianyou Hospital,Affiliated to Wuhan Science and Technology University,Wuhan 430064
  • Online:2016-06-10 Published:2016-05-11

摘要: 目的 观察骨髓干细胞肝动脉移植治疗失代偿期肝硬化的疗效,为失代偿期肝硬化的临床治疗提供新思路和新方法。方法 选择我院感染科的失代偿期肝硬化住院患者87例,年龄27~65岁,平均年龄46.7±8.3岁,其中乙型肝炎肝硬化67例,丙型肝炎肝硬化2例,原发性胆汁性肝硬化8例,酒精性肝硬化9例,原因不明性肝硬化1例。87例失代偿期肝硬化患者在无菌条件下,抽取骨髓200ml,分离纯化骨髓干细胞。在局部麻醉下,将分离的骨髓干细胞经肝动脉移植入肝脏。观察患者移植后第4周的临床疗效、症状改善情况及术后的不良反应。结果 在移植后第4周,患者血浆白蛋白由31.5±5.1g/L升高到33.9±6.0g/L(P<0.01);凝血酶原时间由17.4±5.6s下降到15.8±4.7s(P<0.01);天门冬氨酸氨基转移酶、总胆红素和甲胎蛋白水平在移植前后无差异性变化(P>0.05);胸水消失10例,腹水消失23例,腹胀减轻17例,下肢浮肿消退21例。术中术后未发生严重并发症。结论 骨髓干细胞肝动脉移植治疗失代偿期肝硬化有较好的近期疗效,且安全可靠、不良反应小,值得临床进一步研究。

关键词: 肝硬化, 骨髓干细胞, 肝动脉, 移植

Abstract: Objective To observe the clinic effect of bone marrow stem cell transplantation by hepatic artery on patients with decompensated cirrhosis so as to find a new approach and a new methods to the treatment of severe liver disease. Methods Totally 87 patients with decompensated cirrhosis from our hospital,aged 27 to 65 year old(the average age was 46.7±8.3 year old) were enrolled. Among them,sixty-seven were hepatitis B cirrhosis,two were hepatitis C cirrhosis,eight were primary biliary cirrhosis,nine were alcoholic cirrhosis,and one was cirrhosis of unknown cause.Under sterile condition,200ml of bone marrow was harvested from eighty-seven patients with decompensated cirrhosis,and then BMSCs were isolated and purified. Under local anesthesia,isolated BMSCs were injected into the livers of the patients via hepatic artery.The clinical efficacy,improvement of symptoms and adverse events were observed. Results Four weeks after transplantation,the levels of serum albumin increased from 31.5±5.1g /L to 33.9 ± 6.0g/L(P<0.01);the levels of prothrombin time decreased from 17.4±5.6s to 15.8±4.7s(P<0.01);there were no differences about the levels of aspartate aminotransferase,total bilirubin and alpha-fetoprotein(P>0.05);pleural effusion disappeared in 10 cases,ascites disappeared in 23 cases,abdominal distension alleviated in 17 cases,and lower extremity edema subsided in 21 cases. No serious complications occurred in this series. Conclusion The bone marrow stem cell transplantation by hepatic artery in treatment of patients with decompensated cirrhosis has a good short-term effects without side effects. It should be worthy of further investigation.

Key words: Cirrhosis, Stem cell, Transplantation, Hepatic artery