人脐血干细胞移植联合前列腺素E1治疗肝硬化的临床观察

The clinical effect of human umbilical cord blood stem cell transplantation combined with prostaglandin E1 in the treatment of liver cirrhosis

目的观察人脐血干细胞移植联合前列腺素E1治疗肝硬化的临床效果。方法选取符合诊断标准的肝硬化患者150例。依据患者知情自愿原则以及治疗期间采用的治疗方案,将150例患者分为A、B、C三组,每组患者均为50例。A组给予前列腺素E1治疗;B组给予人脐血干细胞移植治疗;C组给予人脐血干细胞移植联合前列腺素E1治疗。比较观察3组患者治疗前、治疗后3个月肝功能[天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、胆碱酯酶(CHE)、凝血酶原时间(PT)、总胆红素(TBIL)、直接胆红素(DBIL)]、肝纤维化[透明质酸酶(HA)、IV型胶原(CIV)、Ⅲ型前胶原(PCⅢ)、板层素(LN)]各观察指标变化以及术后3个月、6个月、12个月患者临床症状的改善情况、临床疗效、不良反应和并发症发生情况。结果 C组患者在肝功能、肝纤维化的各项观察指标以及临床疗效表现均优于A组和B组(P<0.05),但A组与B组患者在上述观察指标比较差异无统计学意义(P>0.05);此外C组患者乏力好转率92%(46/50),腹腔积液减少率94%(47/50),肝病蜘蛛痣、面容以及肝掌减轻率72%(36/50)等临床症状改善情况均显著优于A组和B组,差异具有统计学意义(P<0.05)。三组患者在不良反应和并发症发生方面比较差异无统计学意义(P>0.05)。结论人脐血干细胞移植联合前列腺素E1治疗肝硬化,可以明显改善肝硬化患者的临床症状、改善肝功能、肝纤维化等的各项观察指标,并且安全性高,疗效好,值得临床推广应用。

Objective Observe the clinical effect of human umbilical cord blood stem cell transplantation combined with prostaglandin E1 in the treatment of liver cirrhosis. Methods 150 cirrhotic patients,who met the WHO diagnostic criteria were selected. Based on the principle of voluntary and informed patient during treatment regimen used,150 patients were divided into A,B,C three groups,and each group included 50 cases. Group A was given prostaglandin E1 therapy; Group B was given human umbilical cord blood stem cell transplantation therapy; Group C performed human umbilical cord blood stem cell transplantation combined with prostaglandin E1. Comparison of liver function（ ALT,TB,PT,ALB）,fibrosis（ HA,PC- III,C- IV,LN） in the three groups were observed between before treatment and after three months,and the improvement of clinical symptoms were compared among postoperative 3 month,6 months,and 12 months,as well as clinical efficacy,adverse reactions and complications. Results Group C patients were superior than group A and B in the indicators of liver function,liver fibrosis and clinical efficacy（ P〈0. 05）. But the difference was not statistically significant between group A and B（ P〈0. 05）. In addition,fatigue improvement rate in group C patients of 92%（ 46 /50）,ascites to reduce the rate of 94%（ 47 /50）,liver disease,spider veins,liver palms face and reduce the rateof 72%（ 36 /50） and other clinical symptom improvement was significantly better than in group A and group B,the difference was statistically significant（ P〈0. 05）. But three groups of patients in terms of adverse reactions and complications difference was not statistically significant（ P 0. 05）. Conclusion Human umbilical cord blood stem cell transplantation combined with prostaglandin E1 is worthy of clinical application in the treatment of liver cirrhosis.