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

Abstract

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

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.

References

[1] 韩莹,丁惠国.抗病毒治疗乙型肝炎肝硬化的过去、现在和将来.实用肝脏病杂志,2015,18(5):453-456.
[2] Todeschi MR,El BR,Capelli C,et al.Transplanted umbilical cord mesenchymal stem cells modify the in vivo microenvironment enhancing angiogenesis and leading to bone regeneration.Stem Cells Develop,2015,24(13):1570-1581.
[3] Cheng Y,Ping J,Xu HD,et a1.Synergistic effect of a novel oxymatrine-baicalin combination against hepatitis B virus replication smooth muscle actin expression and type I collagen synthesis in vitro.WJG,2006,12(32):51-53.
[4] 中华医学会肝病学分会和感染病学分会.慢性乙型肝炎防治指南(2015年版).实用肝脏病杂志,2016,19(3):V-XXⅢ.
[5] Foster GR,Irving WL,Cheung MC,et al.Impact of direct acting antiviral therapy in patients with chronic hepatitis C and decompensated cirrhosis. J Hepatol,2016,64(6):1224-1231.
[6] Friedenstein AJ,Piatetzkyshapiro II,Petrakova KV.Osteogenesis in transplants of bone marrow cells. J Embryol Exp Morphol,1966,16(3):381-390.
[7] Zappia E,Casazza S,Pedemonte E,et al.Mesenchymal stem cells ameliorate experimental autoimmune encephalomyelitis inducing T-cell anergy. Blood,2016,106(5):1755-1761.
[8] Turgeman G,Pittman DD,Müller R,et al.Engineered human mesenchymal stem cells:a novel platform for skeletal cell mediated gene therapy. J Gene Med,2015,3(3):240-251.
[9] 方雪晴,张骏飞,宋海燕,等. 间充质干细胞移植及其在失代偿期肝硬化中的研究进展. 中华传染病杂志,2016,34(8):509-512.
[10] 方雪晴,张骏飞,宋海燕,等.脐带间充质干细胞移植对失代偿期乙型肝炎肝硬化患者免疫功能和转归的影响.中华肝脏病杂志,2016,24(12):907-910.
[11] Secunda R,Vennila R,Mohanashankar AM,et al.Isolation,expansion and characterisation of mesenchymal stem cells from human bone marrow,adipose tissue,umbilical cord blood and matrix:a comparative study. Cytotechnology,2015,67(5):793-807.
[12] Long Y,Lin XT,Zeng KL,et al.Efficacy of intramuscular matrine in the treatment of chronic hepatitis B.Hepatobiliary Pancreat Dis Int,2004,3(1):69-72.
[13] Curry M P,O'Leary JG,Bzowej N,et al.Sofosbuvir and velpatasvir for HCV in patients with decompensated cirrhosis.New Engl J Med,2015,373(27):2618-2618.
[14] Li CQ,Zhu YT,Zhang FX,et al.Anti-HBV effect of liposome- encapsulated matrine in vitro and in vivo.World J Gastroenterol,2005,11(3):426-428.
[15] 陈佳欣,沈宏辉,刘晓琼,等. 苦参碱类生物碱联合恩替卡韦抗耐药HBV的作用效果及机制分析简.中国实验方剂学杂志,2017,23(1):107-113.
[16] Long Y,Lin XT,Zeng KL,et al.Efficacy of intramuscular matrine in the treatment of chronic hepatitis B.Hepatobiliary Pancreat Dis Int,2004,3(1):69-72.
[17] Aliaghaei A,Gardaneh M,Maghsoudi N,et al.Dopaminergic induction of umbilical cord mesenchymal stem cells by conditioned medium of choroid plexus epithelial cells reduces apomorphine-induced rotation in parkinsonian rats.Arch Iran Med,2016,19(8):561-561.
[18] Burr SP,Dazzi F,Garden OA.Mesenchymal stromal cells and regulatory T ceils:the Yin and Yang of peripheral tolerance.Immunol Cell Biol,2012,91(1):12-18.
[19] Engela AU,Hoogduijn MJ,Boer K,et a1.Human adipose tissue derived mesenchymal stem cells induce functional de-novo regulatory T cells with methylated FOXP3 gene DNA.Clin Exp Immunol,2013,173(2):343-354.
[20] Gu XB,Yang XJ,Wang D,et a1.Relationship between serum HBV DNA level and HBV-specific,nonspecific eytotoxie T lymphocytes and natural killer cells in patients with chronic hepatitis B.Chin Med J,2009,122(8):2129-2132.

Efficacy of intrahepatic transplantation of human umbilical cord mesenchymal stem cells combined with matrine in the treatment of patients with decompensated hepatitis B cirrhosis

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